| NPI | 1689849739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA E RUDY Office Manager 360-676-0642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA de00007519) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-09-09 |