| NPI | 1568819209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CHARLES SHOFF Orthodontist 360-676-1401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: WA DE 60289983) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-05-25 |