Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | H05005 | AZ |
NPI | 1003212135 |
---|---|
Provider Name | Denise Cartier |
First Address | Prescott, AZ 86305-2143 |
Second Address | Prescott, AZ 86305-7131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2014 |
Last Update Date | 17/11/2014 |