| NPI | 1639358021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVERN HENRY SWENSON Dentist Owner 360-452-4615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE00004802) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2007-11-01 |