| NPI | 1578686325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTEL R JENKINS President 425-228-6780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE00004505) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |