| Organization Name: | NEW ERA DENTURE SERVICE |
| NPI Number: | 1336522069 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHANIE J HEMENWAY (OWNER) |
| Mailing Address: | 209 W. Main St. Morton |
| State: | WA US |
| Postal Code: | 98356 |
| Phone Number: | 3604966196 |
| Fax Number: | 3604965467 |
| NPI Enumeration Date: | 06/30/2015 |
| NPI Last Update Date: | 06/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 122400000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Denturist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |