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
Phone: (509) 755-5437
Fax: (509) 755-0444
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003986381 | NPPES |
| Washington | MEDICAID | 5038211 | |
| Washington | MEDICAID | 5038195 |
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