| NPI | 1861602294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL A. O'BRIEN Owner 253-582-2408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00008789) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |