| NPI | 1760564538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABINA GOOBES Secretary 425-746-6090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE8930) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE9742) |
| 122400000X Denturist (Licence: WA DN0141) | |
| 122400000X Denturist (Licence: WA DN0189) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-08-22 |