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Dental Hygienist

Keller, Texas

Provider NPI: 1316175011

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
Tel: 817-518-1100  Fax: 817-518-1106

Business Mailing Address:
Tel: 817-439-2827  Fax: --

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y124Q00000XDental Providers
Dental Hygienist

Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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