| NPI | 1851693337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN JAY SMITH Dentist Owner 509-466-2373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE60311143) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: ID 04171) |
| Enumeration Date | 2010-12-03 |
| Last Update Date | 2012-10-08 |