| NPI | 1760447122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD GEORGE DOLGASH President 360-456-8610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: WA 4068) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2023-03-07 |