MEDICARE: SHARON HELLER DOBECK RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	9200	CA

General Provider Information

NPI Number	:	1205042066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON HELLER DOBECK RDH

Provider Business Mailing Address
First Line	:	1243 7TH ST
Second Line	:	SUITE A
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-1605
Country	:	US
Telephone Number	:	310-451-5348
Fax Number	:	310-656-2565

Provider Business Practice Location Address
First Line	:	1243 7TH ST
Second Line	:	SUITE A
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-1605
Country	:	US
Telephone Number	:	310-451-5348
Fax Number	:	310-656-2565

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	07/08/2007

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