| NPI | 1578054342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADEEM S. ESMAIL Physician/Dentist 360-671-4859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: WA DE60150330) |
| Enumeration Date | 2018-05-28 |
| Last Update Date | 2018-05-28 |