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General NPI Number Information
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NPI Number | 1619747714
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Entity Type | Individual
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Provider Name | HEATHER KISS RDH
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Gender | Female
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Dates
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Enumeration Date | 01/09/2024
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 860 JAMACHA RD STE 201
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City | EL CAJON
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State | CA
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Zip | 92019-3224
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Country | US
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Telephone | 619-593-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1537 WYATT PL
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City | EL CAJON
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State | CA
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Zip | 92020-2320
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Country | US
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Telephone | 619-300-9980
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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 | 16564
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License Number State | CA
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