Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | H4550 | AZ |
NPI | 1033286786 |
---|---|
Provider Name | Ms. Cher L Anderson |
First Address | Queen Creek, AZ 85242-0981 |
Second Address | Mesa, AZ 85205-7000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |