| NPI | 1760655005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETSY M WARD Office Manager 509-575-0419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE00010004) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-04-08 |