| NPI | 1669920971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVIN DICKINSON Onwer/Dentist 360-435-3661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE60372263) |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-09-15 |