Provider Demographics
NPI:1588857726
Name:ENDTER, PAUL DONALD (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DONALD
Last Name:ENDTER
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 1:9725 182ND AVE E
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-6034
Mailing Address - Country:US
Mailing Address - Phone:253-862-7199
Mailing Address - Fax:
Practice Address - Street 1:9725 182ND AVE E
Practice Address - Street 2:
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-6034
Practice Address - Country:US
Practice Address - Phone:253-862-7199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010157122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist