| NPI | 1871673301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY W LOVERIDGE Owner 509-783-1960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00007618) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00008974) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE00009527) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |