| NPI | 1689888158 |
|---|---|
| Doing Business As | PRAIRIE DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | TIFFANY SMITH Office Manager 360-944-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60171756) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00007532) |
| 1223G0001X Dentist, General Practice (Licence: WA DE00010195) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2016-04-18 |