| NPI | 1740574060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY E TAYLOR President 509-529-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE 00008680) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2011-06-03 |