# ANGUS SQUARE DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912226127
- **Authorized official:** SAMUEL B HARKER DDS (PRESIDENT/DENTIST)
- **Authorized official phone:** (509) 783-4194

## Contact information

- **Practice address:** 407 N CONWAY ST, KENNEWICK, WA 99336-3047
- **Practice address phone:** (509) 783-4194
- **Practice address fax:** (509) 735-2196
- **Mailing address:** 407 N CONWAY ST, KENNEWICK, WA 99336-3047
- **Mailing address phone:** (509) 783-4194
- **Mailing address fax:** (509) 735-2196

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 10931 | WA | — |
| 122300000X | Dentist | 9911 | WA | Yes |

## Other

- **Enumeration date:** 05/27/2010
- **Last updated:** 05/27/2010