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General NPI Number Information
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NPI Number | 1467855544
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Entity Type | Individual
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Provider Name | JENNIFER KOLB RDH
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Gender | Female
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 241 18TH ST S
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City | ARLINGTON
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State | VA
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Zip | 22202-3405
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Country | US
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Telephone | 909-338-5965
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Fax |
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Provider Business Mailing Address
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Address Line | 6315 JOAQUIN MURIETA AVE APT D
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City | NEWARK
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State | CA
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Zip | 94560-5429
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Country | US
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Telephone | 760-525-8582
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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 | 26523
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License Number State | CA
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