| NPI | 1699119495 |
|---|---|
| Doing Business As | MOSES LAKE PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | GEOFFREY T PING Owner/President 509-664-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 00010971) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 00010971) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2013-04-23 |