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NPI Code Detail

MEDICARE: HEIDI CLAIRE LYNN DESMARAIS RDH

MEDICARE:   HEIDI CLAIRE LYNN DESMARAIS  RDH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental Hygienist00005448WA

General Provider Information

NPI Number : 1770008633
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI CLAIRE LYNN DESMARAIS RDH
Provider Business Mailing Address
First Line : 4095 MAPLE LN
Second Line :
City : WEST RICHLAND
State : WA
Zip : 99353-9045
Country : US
Telephone Number : 509-670-2226
Fax Number :
Provider Business Practice Location Address
First Line : 4095 MAPLE LN
Second Line :
City : WEST RICHLAND
State : WA
Zip : 99353-9045
Country : US
Telephone Number : 509-670-2226
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2017
Last Update Date : 07/21/2022

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Directions to “ HEIDI CLAIRE LYNN DESMARAIS RDH” Practice Location

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