Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 8032 | AZ |
NPI | 1073147542 |
---|---|
Provider Name | Rosaura Melero |
First Address | Tucson, AZ 85705-7687 |
Second Address | Tucson, AZ 85705-7687 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2020 |
Last Update Date | 24/02/2020 |