| NPI | 1669863668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JAMES PETERSON Member 425-502-9743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00008555) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE60383044) |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2015-02-11 |