| NPI | 1932334539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAHID THOMAS ESHRAGHI Owner 360-574-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00011144) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE00011249) |
| 122300000X Dentist (Licence: WA DE60061018) | |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2009-05-27 |