NPI | 1992183339 |
---|---|
Doing Business As | LACEY MODERN DENTISTRY |
Entity Type | Organization |
Authorized Contact | BRIAN S BIENSTOCK Owner 360-528-7878 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2015-05-18 |
Last Update Date | 2015-05-18 |