Individual
KATHLEEN HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
9000 SW DURHAM RD, BUILDING 710, TIGARD, OR 97224-5539
(503) 359-4057
(503) 359-4756
Mailing address
PO BOX 568, CORNELIUS, OR 97113-0568
(503) 352-8657
(503) 352-8658
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5492
OR
Other
Enumeration date
07/30/2015
Last updated
07/30/2015
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