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General NPI Number Information
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NPI Number | 1578761193
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Entity Type | Individual
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Provider Name | MAK NAI DOHR HYGIENIST
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Gender | Female
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1970 UNIVERSITY AVE
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City | RIVERSIDE
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State | CA
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Zip | 92507-5202
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Country | US
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Telephone | 951-276-0668
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Fax | 951-328-9578
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Provider Business Mailing Address
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Address Line | 1970 UNIVERSITY AVE
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City | RIVERSIDE
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State | CA
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Zip | 92507-5202
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Country | US
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Telephone | 951-276-0668
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Fax | 951-328-9578
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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 | RDH15208
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License Number State | CA
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