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General NPI Number Information
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NPI Number | 1316429319
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Entity Type | Individual
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Provider Name | BETHANIE STORKE RDH
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Gender | Female
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 1 MURRAY HILL DR RM 140
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City | MOUNT MORRIS
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State | NY
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Zip | 14510-1153
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Country | US
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Telephone | 585-243-7847
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Fax |
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Provider Business Mailing Address
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Address Line | 7705 N MAIN ST
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City | SPRINGWATER
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State | NY
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Zip | 14560-9701
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Country | US
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Telephone |
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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 |
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License Number State |
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