| NPI | 1942355979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE LAVERNE KIZAR President 253-584-8840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 122400000X Denturist |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |