| NPI | 1699873844 |
|---|---|
| Other Name | VILLAGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | LISA OLSON Office Admistration 360-697-3331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00006455) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2012-08-14 |