Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 124Q00000X | Dental Hygienist | DH069475 | PA |
Y | 124Q00000X | Dental Hygienist | PHDH000453 | PA |
NPI | 1003305087 |
---|---|
Provider Name | Mrs. Heather Sylvia Link |
First Address | Carrolltown, PA 15722-0209 |
Second Address | Houtzdale, PA 16651-1702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2018 |
Last Update Date | 06/05/2018 |