| NPI | 1922213289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY LON DECOUNTER Dentist Prosthodontist 509-926-7431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA 5922) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: WA 5922) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |