| NPI | 1821027913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY E NELSON Corporation Officer 360-425-7220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2015-02-03 |