| NPI | 1609179357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH EDVALSON Dentist 509-628-8882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00010616) |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2011-01-17 |