| NPI | 1588017545 |
|---|---|
| Doing Business As | JEFFREY D PRUIETT |
| Entity Type | Organization |
| Authorized Contact | JEFFREY DONALD PRUIETT Owner 509-453-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 6385) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |