| NPI | 1588070601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY R ADAMS Dentist 360-357-4578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA DE00005814) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WA DE60483587) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2014-07-09 |