| NPI | 1659480622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOURDES MANCOL ACUESTA Owner 206-322-7706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00005777) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |