| NPI | 1720204266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JED VAL SANTIAGO Owner 425-712-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA DE00009386) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-07-22 |