Individual
AMY HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
12711 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6053
(360) 896-4484
(360) 896-4489
Mailing address
12711 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6053
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
60060516
WA
Other
Enumeration date
10/10/2014
Last updated
10/10/2014
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