| NPI | 1619418498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACH STREIT Owner/Dentist 425-771-3266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WA DE60237532) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: WA DE60237532) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2022-01-27 |