| NPI | 1700031135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDON D. ALLEN Owner 425-670-8670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122400000X Denturist (Licence: WA DN00000017) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE00003007) |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2008-11-26 |