| NPI | 1831267673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL A GRAY President Owner 360-254-5477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA UBI 602-099-728) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2009-08-04 |