| NPI | 1659735199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LEE DESIMONE Office Manager 425-974-8161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 9672) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2016-04-11 |