| NPI | 1811214307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER LELAND STUART Dentist/Owner 360-574-3985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 4261) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2010-04-23 |