| NPI | 1851545768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY HOWDEN ELLISON Owner 509-452-6761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA 5351) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2008-11-06 |