| NPI | 1740698422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOREE DALE OLSON-BOLIN Owner 425-218-2887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA WA6016) |
| Enumeration Date | 2014-07-26 |
| Last Update Date | 2014-07-26 |