| NPI | 1720601099 |
|---|---|
| Doing Business As | WILDCREEK DENTAL |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANNE FASSBURG BRAY Officer/Dentist 206-818-3297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2020-05-21 |