| NPI | 1700339751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BASIL LARCHER Oral Surgeon 253-850-8075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2016-07-26 |