Herzog, Christopher W

Herzog, Christopher W is an individual health care provider with primary practice located at 605 E Holland Ave Ste 222 , Spokane WA 99218-1246. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Herzog, Christopher W can be contacted via phone (509) 755-5437.

Contact Information

Primary practice address
605 E Holland Ave Ste 222 Spokane WA 99218-1246
Fax: (509) 755-0444
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 10414 Washington

Profile Details

NPI number 1003986381
LBN Legal business name Herzog, Christopher W
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2006
Last updated Jul 9th, 2007 - about 17 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 1003986381 NPPES
Washington MEDICAID 5038211
Washington MEDICAID 5038195

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