| NPI | 1902032899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES KENT BAGLEY Dental Provider 509-547-1632 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE 3657) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-06-05 |