| NPI | 1780110395 |
|---|---|
| Doing Business As | ELEVEN ELEVEN DENTAL |
| Entity Type | Organization |
| Authorized Contact | CHELSEA NAGEL Operations Manager 360-357-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2017-05-03 |