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General NPI Number Information
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NPI Number | 1407386535
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Entity Type | Individual
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Provider Name | ROBIN RODERICK RDH, BSDH, MSDH
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Gender | Female
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Dates
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Enumeration Date | 06/12/2017
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Last Update Date | 08/31/2017
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Provider Practice Location Address
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Address Line | 2510 W. 35TH AVE
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City | KENNEWICK
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State | WA
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Zip | 99337
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Country | US
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Telephone | 206-890-3881
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Fax |
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Provider Business Mailing Address
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Address Line | 2510 W 35TH AVE
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City | KENNEWICK
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State | WA
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Zip | 99337-3045
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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 | DH00006131
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License Number State | WA
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