| NPI | 1811589781 |
|---|---|
| Doing Business As | PACIFIC AVE DENTAL |
| Entity Type | Organization |
| Authorized Contact | ALLAN LEE HABLUTZEL Owner 360-373-3515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2021-02-10 |