Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 104884 | CA |
NPI | 1003343708 |
---|---|
Provider Name | Dr. Arlene Teana Zakia Moore Younan |
First Address | Arcata, CA 95521-6249 |
Second Address | Fortuna, CA 95540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2017 |
Last Update Date | 28/10/2020 |