Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH067567 | PA |
NPI | 1003456401 |
---|---|
Provider Name | Cheryl Ann Ross |
First Address | Camp Hill, PA 17011-3832 |
Second Address | Camp Hill, PA 17011-3832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2020 |
Last Update Date | 14/01/2020 |