| NPI | 1841643939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAELEEN GAY Dental Receptionist 509-534-2673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA 5172) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |