Provider Demographics
NPI:1801880018
Name:VARUGHESE, GEORGE K (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:K
Last Name:VARUGHESE
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 1:345 E PINE AVE
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-2454
Mailing Address - Country:US
Mailing Address - Phone:541-564-4449
Mailing Address - Fax:541-564-4591
Practice Address - Street 1:345 E PINE AVE
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-2454
Practice Address - Country:US
Practice Address - Phone:541-564-4449
Practice Address - Fax:541-564-4591
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD76791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice