| NPI | 1689111999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMMI HANSEN Office Manager 206-525-6636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE60231280) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |