| NPI | 1669926515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD ANDREW KOONTZ Owner 425-338-0666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 6865) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2016-08-09 |