| NPI | 1952883993 |
|---|---|
| Doing Business As | DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | ANGIE TREPTOW Interim Director Of Finance 206-299-1937 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2024-05-20 |