| NPI | 1790142701 |
|---|---|
| Doing Business As | CHILDRENS DENTAL VILLAGE |
| Entity Type | Organization |
| Authorized Contact | KIRK E FUHRIMAN Owner 509-863-9460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00010409) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |