Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 27868 | CA |
NPI | 1023679784 |
---|---|
Provider Name | Karrie White |
First Address | North Hills, CA 91343 |
Second Address | North Hills, CA 91343-5824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2019 |
Last Update Date | 24/06/2019 |