| NPI | 1639489479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER DOUGLAS KLEIN Owner, Oral Surgeon 509-943-6686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: WA DE00004943) |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: OR D4952) |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2010-10-14 |