Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 30427 | CA |
NPI | 1013456417 |
---|---|
Provider Name | Neven Georgey |
First Address | Fountain Valley, CA 92708-5723 |
Second Address | Orange, CA 92868-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2017 |
Last Update Date | 17/02/2017 |