| NPI | 1700297967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYANTHI BANTWAL Dentist 253-277-2620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 9467) |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2014-05-09 |