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Individual
DR. DEBRA M. ENNEKING
Active
Individual
DR. DEBRA M. ENNEKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7066
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5017397
DEPT OF SOCIAL & HEALTH
WA
01
—
57066
WASHINGTON DENTAL SERVICE
WA
01
—
896356
UNITED CONCORDIA INS.
—
Enumeration date
12/20/2006
Last updated
08/13/2013
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