Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 7217 | WA |
NPI | 1083837470 |
---|---|
Provider Name | Dr. David S Mehlhaff |
First Address | Vancouver, WA 98661-2348 |
Second Address | Vancouver, WA 98661-2348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |