| NPI | 1689458473 |
|---|---|
| Doing Business As | BONNEY LAKE RAINIER |
| Entity Type | Organization |
| Authorized Contact | MALIA WARE Hr 253-242-8816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-08-22 |
| Last Update Date | 2023-08-22 |