| Hernas Dental | |
|
100 3rd St Suite 3 Davenport WA 99122-5008 | |
| (509) 725-6281 | |
| (509) 725-6282 |
| Full Name | Hernas Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 100 3rd St, Davenport, Washington |
| Authorized Official Name and Position | Knute J Hernas (OWNER/PRESIDENT) |
| Authorized Official Contact | 5097256281 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hernas Dental 100 3rd St Suite 3 Davenport WA 99122-5008 Ph: (509) 725-6281 | Hernas Dental 100 3rd St Suite 3 Davenport WA 99122-5008 Ph: (509) 725-6281 |
| NPI Number | 1891940789 |
|---|---|
| Provider Enumeration Date | 11/19/2008 |
| Last Update Date | 11/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891940789 | NPI | - | NPPES |
| 5036009 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 601835986 (Washington) | Primary |
Davenport Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 707 Logan St, Davenport, WA 99122 Phone: 509-725-1181 Fax: 509-725-1182 |