| NPI | 1922116003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRET JACOBSON Owner 253-839-4111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00008218) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2020-08-22 |