| NPI | 1801049366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FOREST MICHAEL FARLEY President 253-838-2018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA 4337) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-10-28 |