| NPI | 1932404175 |
|---|---|
| Doing Business As | OLYMPIC PENINSULA IMPLANTS & PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | STIG KJELL OSTERBERG President 360-385-5121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: WA DE00005095) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DE00005347) |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2011-01-19 |