Dr. David C Haderlie, DDS
Dentist, Endodontics in Moses Lake, WA. Individual provider (NPI-1).
NPI number1528296399
StatusActive
Last updated in NPPESAug 4, 2022
Details
- NPI
- 1528296399
- Entity type
- Individual (NPI-1)
- Name
- Dr. David C Haderlie
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 30, 2009
- Certification date
- Aug 4, 2022
- Last updated
- Aug 4, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223E0200X | Dentist, Endodontics | DE60720894 | WA | Yes |
| 122300000X | Dentist | D4237 | ID | |
| 122300000X | Dentist | DE60720894 | WA | |
| 1223E0200X | Dentist, Endodontics | 60720894 | WA |
Practice location
605 S Coolidge StMoses Lake, WA 98837-1873
Phone 509-765-0674
Mailing address
263 Farmington AveFarmington, CT 06030-0002
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.