| NPI | 1972057693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADHURI VANAMA Doctor 425-295-7975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE00009946) |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2016-08-10 |