Most Relevant Information
Provider Data
| NPI Number: | 1003277104 |
| Provider Name: | SVETLANA ANENKO |
| Entity Type: | Individual |
| Taxonomy Code: | 126800000X |
| Specialty: | Dental Assistant |
| License Number: | TIN # 93-0798039 |
Most Important Dates
| Enumeration Date: | 03/16/2016 |
| Last Updated: | 03/16/2016 |
Provider Practice Location
12711 SE MILL PLAIN BLVD
VANCOUVER
WA
986846053
Practice Location Phone/Fax
| Phone: | 3608964484 |
| Fax: | 3608964489 |
Provider Mailing Location
12711 SE MILL PLAIN BLVD
VANCOUVER
WA
986846053
Provider Mailing Phone/Fax
| Phone: | 3608964484 |
| Fax: | 3608964489 |