NPI | 1609459346 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH L HANCOCK Dentist/Owner 360-753-7388 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122400000X Denturist |
Enumeration Date | 2021-04-30 |
Last Update Date | 2021-04-30 |