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NPI Code Detail

MEDICARE: JAN CHRISTIAN BUDO RDH

MEDICARE:   JAN CHRISTIAN BUDO  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 Hygienist2147NV

General Provider Information

NPI Number : 1801064399
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAN CHRISTIAN BUDO RDH
Provider Business Mailing Address
First Line : BOX 837
Second Line :
City : APO
State : AP
Zip : 96555
Country : US
Telephone Number : 805-355-2493
Fax Number : 805-355-2174
Provider Business Practice Location Address
First Line : BOX 1700
Second Line :
City : APO
State : AP
Zip : 96555
Country : US
Telephone Number : 805-355-2165
Fax Number : 805-355-2174
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2008
Last Update Date : 04/20/2008

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Directions to “ JAN CHRISTIAN BUDO RDH” Practice Location

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