| NPI | 1730148248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN R CHENEY Owner 360-794-5788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA de00008524) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2012-10-03 |