NPI | 1952550758 |
---|---|
Entity Type | Organization |
Authorized Contact | OLGA V RAZUMOVICH Officer 206-542-2196 |
Organization Subpart ? | No |
Primary Taxonomy | 122400000X Denturist (Licence: WA DN60034321) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE000010385) |
1223G0001X Dentist, General Practice (Licence: WA DE00009387) | |
Enumeration Date | 2008-09-17 |
Last Update Date | 2008-09-17 |