| Organization Name: | ADVANCED PEDIATRIC DENTISTRY OF HERMISTON, LLS |
| NPI Number: | 1134308810 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | J. KYLE HOUSE (DENTIST) |
| Mailing Address: | 1060 W Elm Ave Ste 115 Hermiston |
| State: | OR US |
| Postal Code: | 978382723 |
| Phone Number: | 5412895433 |
| Fax Number: | |
| NPI Enumeration Date: | 10/30/2007 |
| NPI Last Update Date: | 01/15/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | D9044 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |