Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 6742 | AZ |
NPI | 1033554274 |
---|---|
Provider Name | Pegg Rohner |
First Address | Scottsdale, AZ 85254-5240 |
Second Address | Scottsdale, AZ 85254-5240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2013 |
Last Update Date | 01/05/2013 |