| NPI | 1821400433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOAN T NGUYEN Owner 360-791-7019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE60216703) |
| Enumeration Date | 2014-05-30 |
| Last Update Date | 2014-05-30 |