Organization
LARRY HEGGERNESS SOCIAL PURPOSE PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY K HEGGERNESS DDS (PRESIDENT)
(206) 242-4121
Entity
Organization
Contact information
Practice address
6720 FORT DENT WAY STE 120, TUKWILA, WA 98188-2580
(206) 242-4121
(206) 242-4113
Mailing address
6720 FORT DENT WAY STE 120, TUKWILA, WA 98188-2580
(206) 242-4121
(206) 242-4113
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DE00003686
WA
Other
Enumeration date
01/15/2013
Last updated
01/15/2013
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