| NPI | 1861931677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HARALSON Owner 206-624-0852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA 603252090) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |