Individual
DR. DAVID C HADERLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
605 S COOLIDGE ST, MOSES LAKE, WA 98837-1873
(509) 765-0674
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0002
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D4237
ID
122300000X
Dentist
DE60720894
WA
1223E0200X
Endodontics
60720894
WA
1223E0200X
Endodontics
Primary
DE60720894
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2016334
—
WA
Enumeration date
06/30/2009
Last updated
08/04/2022
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