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General NPI Number Information
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NPI Number | 1336748896
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Entity Type | Individual
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Provider Name | CYNTHIA GARCIA MACDOUGALL
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Gender | Female
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Dates
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Enumeration Date | 10/25/2020
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Last Update Date | 01/23/2021
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Provider Practice Location Address
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Address Line | 444 HERMOSA AVE APT 302
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-4433
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Country | US
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Telephone | 310-376-9001
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Fax |
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Provider Business Mailing Address
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Address Line | 444 HERMOSA AVE APT 302
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-4433
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Country | US
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Telephone | 310-376-9001
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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 | 23320
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 805
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License Number State | CA
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