| NPI | 1700826310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN WILLIAM BOIE Chief Financial Officer 360-571-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: 1223G0001X) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2014-11-12 |