Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 124Q00000X | Dental Hygienist | 10012 | MN |
NPI | 1053829721 |
---|---|
Provider Name | Rhonda Jean Schwalbe |
First Address | Crystal, MN 55427-1326 |
Second Address | Virginia, MN 55792-2369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2018 |
Last Update Date | 16/01/2018 |