Provider Demographics
NPI:1376649913
Name:BOERS, DANIEL (DDS, MPH)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:BOERS
Suffix:
Gender:M
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 ORONDO AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2800
Mailing Address - Country:US
Mailing Address - Phone:509-662-3860
Mailing Address - Fax:509-664-4585
Practice Address - Street 1:600 ORONDO AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2800
Practice Address - Country:US
Practice Address - Phone:509-662-3860
Practice Address - Fax:509-664-4585
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA76041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA194163OtherUNITED CONCORDIA COMPANY
WA5023171Medicaid
WA8940701OtherLABOR & INDUSTRIES
WA8940701OtherLABOR & INDUSTRIES