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General NPI Number Information
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NPI Number | 1194634923
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Entity Type | Organization
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Legal Business Name | SODA DENTAL HYGIENE PRACTICE OF ASHLEY SHELLEY RDHAP, INC.
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Dates
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Enumeration Date | 09/07/2026
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Last Update Date | 09/07/2026
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Provider Practice Location Address
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Address Line | 720 BROOKSIDE AVE STE 102
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City | REDLANDS
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State | CA
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Zip | 92373-5189
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Country | US
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Telephone | 909-213-7537
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Fax |
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Provider Business Mailing Address
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Address Line | 9453 AVENIDA SAN TIMOTEO
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City | CHERRY VALLEY
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State | CA
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Zip | 92223-4315
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Country | US
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Telephone | 909-213-7537
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MS. ASHLEY NICOLE SHELLEY
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Credential |
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Telephone | 909-213-7537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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