| NPI | 1942611157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BRANDON SCHUTTE Owner 509-547-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE60106594) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2018-04-19 |