| NPI | 1922359744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN V KERR Owner 253-584-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223P0300X Dentist Periodontics |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2012-09-20 |