| NPI | 1962647578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E. TRACY Sole Proprietor 206-362-3833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA 4990) |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2008-12-10 |