| 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 |