| NPI | 1770973133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE BRAITHWAITE Owner/Dentist 509-578-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE 00011018) |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2015-04-23 |