| NPI | 1760970925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARSTEN BRADLEY QUINTON Owner/Dentist 360-770-2183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE60837881) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |