Organization
JEFFREY J. HENNEBERG, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFF HENNEBERG DDS (OWNER)
(509) 928-8400
Entity
Organization
Contact information
Practice address
1215 N MCDONALD RD STE 203, SPOKANE VALLEY, WA 99216-1557
(509) 928-8400
Mailing address
1215 N MCDONALD RD STE 203, SPOKANE VALLEY, WA 99216-1557
(509) 928-8400
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
602629210
WA
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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