| NPI | 1730477431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY D TEW President 509-965-9451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE60164479) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2011-07-14 |