| NPI | 1780121673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHADEEP VIRK Owner 206-786-5351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2017-02-14 |