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General NPI Number Information
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NPI Number | 1902273196
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Entity Type | Organization
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Legal Business Name | DENTAL HYGIENE SERVICES
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 08/24/2015
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Provider Practice Location Address
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Address Line | 26692 BRIDLEWOOD DR
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-7570
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Country | US
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Telephone | 949-328-7895
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Fax |
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Provider Business Mailing Address
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Address Line | 26692 BRIDLEWOOD DR
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-7570
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Country | US
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Telephone | 949-328-7895
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Fax |
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Authorized Official
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Title or Position | REGISTERED DENTAL HYGIENIST
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Name | MRS. EDITH RECHEL ROSALES
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Credential | RDHAP
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Telephone | 949-328-7895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 564
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | 564
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 564
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License Number State | CA
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