Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 02149 | NH |
NPI | 1073170452 |
---|---|
Provider Name | Deborah Carol Ditommaso |
First Address | Rindge, NH 03461-5302 |
Second Address | Keene, NH 03431-3507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2019 |
Last Update Date | 21/05/2019 |