| NPI | 1710381157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE A SMITH Dentist/Owner 360-676-0760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WA DE 8503) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2014-10-14 |