| NPI | 1780003723 |
|---|---|
| Doing Business As | POULSBO CHILDREN'S DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MCKINLEY T SELF Manager 360-464-0779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE10256) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2014-04-07 |