| NPI | 1578294179 |
|---|---|
| Doing Business As | ELLIOTT BAY DENTAL BURIEN |
| Entity Type | Organization |
| Authorized Contact | MISTY CERVANTES-KIM Dentist/Owner 209-406-3057 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2022-06-23 |