| NPI | 1922258961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD CHARLES BASSHAM Director 509-526-7012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WA DE00008030) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2009-01-15 |