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NPI Code Detail

MEDICARE: FERN VANGINHOVEN RDH

MEDICARE: FERN VANGINHOVEN 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 Hygienist20313TX

General Provider Information

NPI Number : 1871169888
Entity Type Code : Individual
Provider Name (Legal Business Name) : FERN VANGINHOVEN RDH
Provider Business Mailing Address
First Line : 100 CROSSING BLVD
Second Line :
City : FRAMINGHAM
State : MA
Zip : 01702-5555
Country : US
Telephone Number : 617-964-6681
Fax Number : 339-686-2561
Provider Business Practice Location Address
First Line : 2413 E LOOP 820 N
Second Line :
City : FORT WORTH
State : TX
Zip : 76118-6933
Country : US
Telephone Number : 888-964-6681
Fax Number : 888-662-0859
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2021
Last Update Date : 06/01/2021

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Directions to “ FERN VANGINHOVEN RDH” Practice Location

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