Healthcare Provider Details

I. General information

NPI: 1417237637
Provider Name (Legal Business Name): DEBORAH ANNE DOWRIE RDHAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2011
Last Update Date: 08/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3567 KILO AVE
SAN JOSE CA
95124-3143
US

IV. Provider business mailing address

1177 BRANHAM LN # 269
SAN JOSE CA
95118-3766
US

V. Phone/Fax

Practice location:
  • Phone: 408-978-9547
  • Fax:
Mailing address:
  • Phone: 408-772-8817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number350 RDHAP
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: