| NPI | 1962001347 |
|---|---|
| Doing Business As | GREEN DENTAL GENERAL & COSMETIC |
| Entity Type | Organization |
| Authorized Contact | MARIDETTE CUNANAN Owner, Dentist 360-990-1034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-10-18 |
| Last Update Date | 2020-10-18 |