| NPI | 1982949640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON DEAN TVETEN Owner 509-662-6857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00008505) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00008492) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2016-03-29 |