Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 00003970 | WA |
NPI | 1003989955 |
---|---|
Provider Name | Dr. Dennis Lee Meidinger |
First Address | Snoqualmie, WA 98065-9773 |
Second Address | Auburn, WA 98002-4700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |