Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 836 | CA |
NPI | 1073271680 |
---|---|
Provider Name | Cynthia M Dillon |
First Address | Hayward, CA 94541-3308 |
Second Address | Hayward, CA 94541-2723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2021 |
Last Update Date | 30/11/2021 |