Individual
MRS. MACY M BIENERTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EFDA
Contact information
Practice address
12711 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6053
(360) 896-4484
Mailing address
24700 NW 24TH AVE, RIDGEFIELD, WA 98642-9415
(360) 887-0062
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
A10295
OR
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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