| NPI | 1801649371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE LADD Owner 509-869-1956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122400000X Denturist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2024-04-08 |