Healthcare Provider Details

I. General information

NPI: 1134599400
Provider Name (Legal Business Name): AMY HUYNH RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10318 ROSECRANS AVE
BELLFLOWER CA
90706-2702
US

IV. Provider business mailing address

10318 ROSECRANS AVE
BELLFLOWER CA
90706-2702
US

V. Phone/Fax

Practice location:
  • Phone: 562-925-3765
  • Fax:
Mailing address:
  • Phone: 562-925-3765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number25359
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: