| NPI | 1942510029 |
|---|---|
| Doing Business As | KENNEWICK DENTAL |
| Entity Type | Organization |
| Authorized Contact | NATHAN MADDER Dentist 509-374-4077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00010244) |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2018-10-09 |