Provider Demographics
NPI:1891962064
Name:HERMA RANOLA DMD PLLC
Entity Type:Organization
Organization Name:HERMA RANOLA DMD PLLC
Other - Org Name:RANIEU FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HERMA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:530-400-6629
Mailing Address - Street 1:7604 NE 5TH AVE
Mailing Address - Street 2:STE. 114
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8200
Mailing Address - Country:US
Mailing Address - Phone:360-735-9422
Mailing Address - Fax:
Practice Address - Street 1:7604 NE 5TH AVE
Practice Address - Street 2:STE. 114
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8200
Practice Address - Country:US
Practice Address - Phone:360-735-9422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010261305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization