Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 1064 | OR |
NPI | 1205847753 |
---|---|
Provider Name | Mrs. Sharon Kay Zertanna |
First Address | Hillsboro, OR 97124-5860 |
Second Address | Hillsboro, OR 97123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 27/09/2012 |