Haderlie, David C

Haderlie, David C is an individual health care provider with primary practice located at 605 S Coolidge St , Moses Lake WA 98837-1873. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Endodontics. Dental Providers / Endodontics is his primary health care specialty. Haderlie, David C can be contacted via phone (509) 765-0674.

Contact Information

Primary practice address
605 S Coolidge St Moses Lake WA 98837-1873
Phone: (509) 765-0674
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X D4237 Idaho
Dental Providers / Dentist 122300000X DE60720894 Washington
Dental Providers / Endodontics 1223E0200X 60720894 Washington
Dental Providers / Endodontics 1223E0200X DE60720894 Washington

Profile Details

NPI number 1528296399
LBN Legal business name Haderlie, David C
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2009
Last updated Aug 4th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528296399 NPPES
Washington MEDICAID 2016334

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