Provider Demographics
NPI:1497013551
Name:LANCE J. HEPPLER, DDS, PS
Entity Type:Organization
Organization Name:LANCE J. HEPPLER, DDS, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:HEPPLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-896-1449
Mailing Address - Street 1:900 SE CHKALOV DR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-5240
Mailing Address - Country:US
Mailing Address - Phone:360-896-1449
Mailing Address - Fax:360-260-2176
Practice Address - Street 1:900 SE CHKALOV DR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5240
Practice Address - Country:US
Practice Address - Phone:360-896-1449
Practice Address - Fax:360-260-2176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA8437332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment