Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | RDA50568 | CA |
NPI | 1073095428 |
---|---|
Provider Name | Rohshana Plunkett |
First Address | Carlsbad, CA 92010 |
Second Address | Santee, CA 92071 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2018 |
Last Update Date | 02/09/2018 |