Great Wall Clinic
NPI #1184952079 in Kent, Washington
Provider Information
- NPI Number
- 1184952079
- Entity Type
- Organization
- Organization Name
- Great Wall Clinic
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Dec 3, 2009
- Last Updated
- Dec 3, 2009
Practice Location
- Address
- 18230 E VALLEY HWY
- Address 2
- 168
- City
- Kent
- State
- Washington
- ZIP Code
- 98032-1259
- Phone
- (425) 656-9025
Authorized Official
- Name
- EPHRAIM ROLLOLAZO
- Title
- OFFICE MANAGER
- Phone
- (425) 656-9025
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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