Organization
ELEVATE DENTAL HYGIENE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE WATKINS RDH (OWNER)
(208) 731-8723
Entity
Organization
Contact information
Practice address
630 SUN VALLEY ROAD SUITE D102, KETCHUM, ID 83340
(208) 731-8723
Mailing address
721 NORTHSTAR DR, HAILEY, ID 83333-8501
(208) 731-8723
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649898578
NPPES
ID
01
—
1851496137
NPPES
ID
Enumeration date
01/11/2021
Last updated
01/11/2021
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