| Rj Henneberg, Pllc | |
|
417 E Broadway Ave Ste 103 Moses Lake WA 98837-3081 | |
| (509) 766-5015 | |
| (509) 855-9070 |
| Full Name | Rj Henneberg, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 417 E Broadway Ave Ste 103, Moses Lake, Washington |
| Authorized Official Name and Position | Kasha Rapp (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 5097650150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rj Henneberg, Pllc 417 E Broadway Ave Ste 103 Moses Lake WA 98837-3081 Ph: (509) 766-5015 | Rj Henneberg, Pllc 417 E Broadway Ave Ste 103 Moses Lake WA 98837-3081 Ph: (509) 766-5015 |
| NPI Number | 1700490356 |
|---|---|
| Provider Enumeration Date | 09/01/2020 |
| Last Update Date | 09/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700490356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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