| NPI | 1659739373 |
|---|---|
| Doing Business As | BALLARD HOMELESS DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | JANINE CHILDS CFO 206-548-3034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2016-02-09 |