| NPI | 1700171410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PARDEEP S BRAR President 360-293-2808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: WA DE00010052) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2013-09-20 |