NPI | 1679127492 |
---|---|
Doing Business As | LOWRY MAIN STREET DENTAL |
Entity Type | Organization |
Authorized Contact | MICHELLE JOHNSON Credentialing Specialist 509-315-8338 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2019-07-30 |
Last Update Date | 2019-07-30 |