| NPI | 1598839748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ROBERTS WELLER President 253-565-0330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE00009898) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |