| NPI | 1720604580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR KENJ TSUCHIKAWA Owner 206-852-6836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2020-06-17 |