| NPI | 1821197989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN K TRANTOW Bookkeeper 509-928-3363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00005493) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WA DH00001414) |
| 124Q00000X Dental Hygienist (Licence: WA DH00005591) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-08-22 |