| NPI | 1790106359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALLAN WOODWARD Dentist 509-467-0755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: WA DE9064) |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2013-12-30 |