Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN00000123 | WA |
NPI | 1174677132 |
---|---|
Provider Name | David Alan Hill |
First Address | University Place, WA 98466-3431 |
Second Address | University Place, WA 98466-3431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5038252 | (05) | WA |