| NPI | 1952798803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA REIKO HOLLIDAY Owner Dentist 206-779-5066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60172193) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |