Individual
ANITA LOUISE BACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1703 HUDSON ST, LONGVIEW, WA 98632-2912
(360) 575-4801
Mailing address
904 NEVADA DR, LONGVIEW, WA 98632-5608
(360) 636-4602
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH00004268
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124Q00000X
RDH
WA
Enumeration date
08/31/2006
Last updated
07/08/2007
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