| Hermiston Dental Group | |
|
540 Sw 11th St Hermiston OR 97838-2108 | |
| (541) 567-4143 | |
| Not Available |
| Full Name | Hermiston Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 540 Sw 11th St, Hermiston, Oregon |
| Authorized Official Name and Position | Pablo E Nicacio (OWNER) |
| Authorized Official Contact | 5415674143 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hermiston Dental Group 540 Sw 11th St Hermiston OR 97838-2108 Ph: (541) 567-4143 | Hermiston Dental Group 540 Sw 11th St Hermiston OR 97838-2108 Ph: (541) 567-4143 |
| NPI Number | 1356511158 |
|---|---|
| Provider Enumeration Date | 03/07/2008 |
| Last Update Date | 03/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356511158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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