Individual
SIDNEY PUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Mailing address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH60292806
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DH60292806
WASHINGTON STATE LICENSE
WA
Enumeration date
12/16/2018
Last updated
02/17/2020
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