NPI | 1568912426 |
---|---|
Doing Business As | NEW IMAGE DENTISTRY |
Entity Type | Organization |
Authorized Contact | JUSTIN BLAKE PERKINS Owner/Dentist 360-604-7151 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: WA DE00008724) |
Enumeration Date | 2016-10-04 |
Last Update Date | 2016-10-04 |