| NPI | 1952052045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEZLY HARTLEY Financial Coordinator/Bookkeeper 360-352-9391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2022-01-11 |