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General NPI Number Information
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NPI Number | 1154101285
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Entity Type | Individual
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Provider Name | CORA L ROCHA PHDH, RDH
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Gender | Female
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 114 COLEBROOK RD
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City | LITTLE COMPTON
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State | RI
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Zip | 02837-2014
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Country | US
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Telephone | 401-418-4671
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Fax |
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Provider Business Mailing Address
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Address Line | 114 COLEBROOK RD
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City | LITTLE COMPTON
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State | RI
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Zip | 02837-2014
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Country | US
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Telephone | 401-418-4671
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | PDH00046
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License Number State | RI
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