Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | RDHAP 528 | CA |
NPI | 1023424611 |
---|---|
Provider Name | Rachael Santsche |
First Address | Arcata, CA 95521-5589 |
Second Address | Arcata, CA 95521-5589 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2014 |
Last Update Date | 03/07/2014 |