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General NPI Number Information
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NPI Number | 1720144033
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Entity Type | Individual
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Provider Name | DARLA DIANE DALE RDHAP
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Gender | Female
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2101 MCCLASKEY LN
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City | EUREKA
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State | CA
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Zip | 95503-6517
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Country | US
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Telephone | 707-476-0100
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Fax | 707-441-1466
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Provider Business Mailing Address
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Address Line | 2101 MCCLASKEY LN
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City | EUREKA
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State | CA
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Zip | 95503-6517
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Country | US
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Telephone | 707-476-0100
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Fax | 707-441-1466
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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 | RDHAP 65
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License Number State | CA
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