Provider Demographics
NPI:1104079136
Name:ERIC P. MESSINGER, DDS, PS
Entity type:Organization
Organization Name:ERIC P. MESSINGER, DDS, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:MESSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-834-3533
Mailing Address - Street 1:2016 NE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-1705
Mailing Address - Country:US
Mailing Address - Phone:360-834-3533
Mailing Address - Fax:
Practice Address - Street 1:2016 NE 3RD AVE
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-1705
Practice Address - Country:US
Practice Address - Phone:360-834-3533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA55971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5024732Medicaid