| NPI | 1730179334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RICHARD AMES President 509-468-1535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA 601821168) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2020-08-22 |