| NPI | 1932238136 |
|---|---|
| Doing Business As | CHILDRENS VILLAGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JUAN CARLOS OLIVARES Executive Director 509-865-6175 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2008-02-12 |