| NPI | 1972705226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL M TAYLOR President 360-568-1519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA DEOOOO5201) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |