Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 17878 | TX |
NPI | 1023369469 |
---|---|
Provider Name | Eugenia G. Tarin |
First Address | Canutillo, TX 79835-0910 |
Second Address | El Paso, TX 79901-2936 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2012 |
Last Update Date | 25/09/2012 |