| NPI | 1710117304 |
|---|---|
| Doing Business As | CHILDRENS DENTAL VILLAGE |
| Entity Type | Organization |
| Authorized Contact | TERI R JACKSON Business Manager 509-891-9011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00010409) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2016-04-28 |