| NPI | 1811319205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEL LYNN BAKER Office Manager 253-939-3440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA DE60086475) |
| Enumeration Date | 2014-01-20 |
| Last Update Date | 2014-01-20 |