NPI | 1629491766 |
---|---|
Doing Business As | WALLA WALLA PEDIATRIC DENTISTRY |
Entity Type | Organization |
Authorized Contact | STACEY RAE KUTSCH Owner Pediatric Dentist 509-378-2520 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00010428) |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: WA DE00010428) |
Enumeration Date | 2014-01-25 |
Last Update Date | 2023-03-07 |