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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LAUREN L. BURSELL (CEO)
(206) 403-5081
Entity
Organization

Contact information

Practice address
25965 TYTLER RD NE, POULSBO, WA 98370-9102
(206) 403-5081
Mailing address
25965 TYTLER RD NE, POULSBO, WA 98370-9102
(206) 403-5081

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
06/29/2017
Last updated
06/29/2017
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