Hermiston Dental Group

NPI #1356511158 in Hermiston, Oregon

Provider Information

NPI Number: 1356511158
Entity Type: Organization
Organization Name: Hermiston Dental Group
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 7, 2008
Last Updated: Mar 7, 2008

Practice Location

Address: 540 SW 11TH ST
City: Hermiston
State: Oregon
ZIP Code: 97838-2108
Phone: (541) 567-4143

Authorized Official

Name: PABLO E NICACIO, DDS
Title: OWNER
Phone: (541) 567-4143

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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