| NPI | 1659625507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOREN P ANDERSON Dentist/Owner 509-585-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE 9925) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-10-30 |