| NPI | 1568615052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANETTE MCINTOSH Business Manager 425-455-0784 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: WA 4233) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-11-17 |