| NPI | 1639305253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL PATRICK GARDNER CEO 360-336-5464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE00008421) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2026-03-20 |