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Organization
SMILES ON THE RUN DENTAL HYGIENE PRACTICE OF KIMBERLY FARRELL RDHAP
Active
Organization
SMILES ON THE RUN DENTAL HYGIENE PRACTICE OF KIMBERLY FARRELL RDHAP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY ANN FARRELL RDHAP (RDHAP / OWNER)
(949) 637-8911
Entity
Organization
Contact information
Practice address
26895 ALISO CREEK RD STE B671, ALISO VIEJO, CA 92656-5301
(949) 637-8911
Mailing address
26895 ALISO CREEK RD STE B671, ALISO VIEJO, CA 92656-5301
(949) 637-8911
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HAP103
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H00103
DENTICAL
CA
Enumeration date
06/11/2012
Last updated
06/11/2012
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