| NPI | 1821162033 |
|---|---|
| Other Name | STILLAGUAMISH FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | BRENDA TATRO Office Manager 360-403-8761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |