| NPI | 1770642704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN D KIMBERLEY President 360-733-7708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 5518) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-08-22 |