| NPI | 1891913042 |
|---|---|
| Doing Business As | OTHELLO DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | JOSHUA BUNCH CFO 509-488-5250 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-09-03 |