Provider Demographics
NPI:1861544991
Name:HOEGER, DAVID LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEE
Last Name:HOEGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-1308
Mailing Address - Country:US
Mailing Address - Phone:509-697-4744
Mailing Address - Fax:
Practice Address - Street 1:112 S 2ND ST
Practice Address - Street 2:
Practice Address - City:SELAH
Practice Address - State:WA
Practice Address - Zip Code:98942-1308
Practice Address - Country:US
Practice Address - Phone:509-697-4744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA025103DE000060941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice