| NPI | 1942279997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES V MISCHEL Owner 425-775-5162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00005091) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE0010360) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-08-22 |