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General NPI Number Information
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NPI Number | 1225902372
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH CENTERS DENTAL
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 1003 B KOALA DR
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City | OMAK
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State | WA
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Zip | 98841-9247
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Country | US
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Telephone | 800-660-2129
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Fax | 855-204-8902
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Provider Business Mailing Address
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Address Line | PO BOX 1340
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City | OKANOGAN
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State | WA
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Zip | 98840-1340
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Country | US
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Telephone | 509-422-7670
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Fax | 509-422-7668
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Authorized Official
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Title or Position | CEO
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Name | JESUS HERNANDEZ
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Credential |
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Telephone | 509-422-7601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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