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Organization
PRODENTAL HYGIENE LLC
Active
Organization
PRODENTAL HYGIENE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIA V HAMBLIN RDH (DENTAL HYGIENIST)
(503) 729-2864
Entity
Organization
Contact information
Practice address
6279 NE CARILLION DR UNIT 103, HILLSBORO, OR 97124-8092
(503) 729-2864
Mailing address
6279 NE CARILLION DR UNIT 103, HILLSBORO, OR 97124-8092
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
311ZA0620X
Adult Care Home Facility
—
—
3140N1450X
Pediatric Skilled Nursing Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/07/2012
Last updated
03/07/2012
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