| NPI | 1679768550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YIYU JADE FANG President 509-438-3044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE00010661) |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2007-09-13 |