| NPI | 1750197976 |
|---|---|
| Other Name | SHILOH DENTAL |
| Entity Type | Organization |
| Authorized Contact | NATHAN HALVORSON Chief Compliance Officer 509-444-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-12-04 |
| Last Update Date | 2024-12-04 |