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NPI Code Detail

MEDICARE: MS. EILEEN FRANCES HASKINS-MOHR RDH

MEDICARE:  MS. EILEEN FRANCES HASKINS-MOHR  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
1124Q00000XDental Hygienist10099NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110099OTHERNVNEVADA STATE DENTAL HYGIENE LICENSE

General Provider Information

NPI Number : 1437479565
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EILEEN FRANCES HASKINS-MOHR RDH
Provider Business Mailing Address
First Line : 3074 ARVILLE ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-7490
Country : US
Telephone Number : 702-889-3763
Fax Number : 702-889-3591
Provider Business Practice Location Address
First Line : 4145 JIMMY DURANTE BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89122-5431
Country : US
Telephone Number : 702-521-4550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2010
Last Update Date : 03/05/2012

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Directions to “ MS. EILEEN FRANCES HASKINS-MOHR RDH” Practice Location

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