| NPI | 1750535001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOACHIM LANEY Owner 509-765-5141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: WA MD00024468) |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2008-11-13 |