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Individual

DR. LYLE EDWARD FERCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
617 E COLLINS ST, GOLDENDALE, WA 98620-9213
(509) 773-6620
(509) 773-6718
Mailing address
617 E COLLINS ST, GOLDENDALE, WA 98620-9213
(509) 773-6620
(509) 773-6718

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00006589
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5013024
WA
Enumeration date
05/02/2012
Last updated
05/02/2012
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