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NPI Code Detail

MEDICARE: JESSICA JOSHUA RDH

MEDICARE:   JESSICA  JOSHUA  RDH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental HygienistDH011827GA

General Provider Information

NPI Number : 1659025427
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA JOSHUA RDH
Provider Business Mailing Address
First Line : 200 GULFSTREAM RD
Second Line :
City : GARDEN CITY
State : GA
Zip : 31408-9677
Country : US
Telephone Number : 912-965-6227
Fax Number :
Provider Business Practice Location Address
First Line : 200 GULFSTREAM RD
Second Line :
City : GARDEN CITY
State : GA
Zip : 31408-9677
Country : US
Telephone Number : 912-965-6227
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2022
Last Update Date : 02/09/2022

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Directions to “ JESSICA JOSHUA RDH” Practice Location

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