| NPI | 1710437017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE MARY HAKES Dentist/Owner 509-464-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE 00006665) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE 60575246) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |