| NPI | 1730532037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESA BROGAN Office Manager 360-538-0290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE60373456) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2016-07-21 |