| NPI | 1588992721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WALLACE MORRISON Owner 509-751-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE 00011204) |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2009-11-30 |