| NPI | 1609194059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRIDEVI VIJAYASEKARAN President 360-456-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00009476) |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2010-05-10 |