| NPI | 1710431796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH J COLLINS Dentist/Owner 509-532-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: WA 8105) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2016-08-08 |