| Angus Square Dental | |
|
407 N Conway St Kennewick WA 99336-3047 | |
| (509) 783-4194 | |
| (509) 735-2196 |
| Full Name | Angus Square Dental |
|---|---|
| Speciality | Dentist |
| Location | 407 N Conway St, Kennewick, Washington |
| Authorized Official Name and Position | Samuel B Harker (PRESIDENT/DENTIST) |
| Authorized Official Contact | 5097834194 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Angus Square Dental 407 N Conway St Kennewick WA 99336-3047 Ph: (509) 783-4194 | Angus Square Dental 407 N Conway St Kennewick WA 99336-3047 Ph: (509) 783-4194 |
| NPI Number | 1912226127 |
|---|---|
| Provider Enumeration Date | 05/27/2010 |
| Last Update Date | 05/27/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912226127 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 9911 (Washington) | Primary |
| 122300000X | Dentist | 10931 (Washington) | Secondary |
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