Healthcare Provider Details

I. General information

NPI: 1386780229
Provider Name (Legal Business Name): DANNA RICA QUIMSON ALON R.D.H.A.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 09/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2963 BOWERY LN
SAN JOSE CA
95135-1543
US

IV. Provider business mailing address

2963 BOWERY LN
SAN JOSE CA
95135-1543
US

V. Phone/Fax

Practice location:
  • Phone: 408-274-8057
  • Fax: 408-715-0135
Mailing address:
  • Phone: 408-348-0139
  • Fax: 408-715-0135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDHAP164
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: