| NPI | 1699962670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG EMENS Business Manager 425-402-8393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: WA DE00010338) |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2007-10-03 |