| NPI | 1902130560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN Y. PONG General Dentist/ Owner 253-927-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 602955173) |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2009-09-29 |