Provider Demographics
NPI:1407100589
Name:DREHOBL, ANNETTE MARIE (RDH)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:MARIE
Last Name:DREHOBL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MS
Other - First Name:ANNETTE
Other - Middle Name:MARIE
Other - Last Name:BACHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11912 SE 15TH ST.
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-6218
Mailing Address - Country:US
Mailing Address - Phone:360-885-2734
Mailing Address - Fax:
Practice Address - Street 1:11912 SE 15TH ST.
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-6218
Practice Address - Country:US
Practice Address - Phone:360-885-2734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH4035124Q00000X
WAHL00007073124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist