Organization
HERMISTON DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PABLO E NICACIO DDS (OWNER)
(541) 567-4143
Entity
Organization
Contact information
Practice address
540 SW 11TH ST, HERMISTON, OR 97838-2108
(541) 567-4143
Mailing address
540 SW 11TH ST, HERMISTON, OR 97838-2108
(541) 567-4143
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/07/2008
Last updated
03/07/2008
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