| NPI | 1841745247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORIN D PETERSON Owner/Dentist 509-674-5153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE00005472) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2016-08-16 |