| NPI | 1699820019 |
|---|---|
| Doing Business As | BONNEY LAKE FAMILY DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | OTTO JULIUS HANSSEN President 253-826-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |