Healthcare Provider Details

I. General information

NPI: 1457915498
Provider Name (Legal Business Name): SARAH MICHELLE ESCOCHEA R.D.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2019
Last Update Date: 04/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CAMP SCHWAB DENTAL CLINIC
FPO AP
96388
US

IV. Provider business mailing address

PSC 563 BOX 7122
FPO AP
96388-0072
US

V. Phone/Fax

Practice location:
  • Phone: 501-772-5868
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2594
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: