| NPI | 1972900942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM RIOUX Owner/Dentist 253-857-6778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA 8549) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WA 8549) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2014-11-19 |