Provider Demographics
NPI:1902862709
Name:MAX W HIGBEE DMD PC
Entity Type:Organization
Organization Name:MAX W HIGBEE DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:W
Authorized Official - Last Name:HIGBEE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:541-548-8175
Mailing Address - Street 1:1765 SW PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-2550
Mailing Address - Country:US
Mailing Address - Phone:541-548-8175
Mailing Address - Fax:541-548-7025
Practice Address - Street 1:1765 SW PARKWAY DR
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2550
Practice Address - Country:US
Practice Address - Phone:541-548-8175
Practice Address - Fax:541-548-7025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD44391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty