Individual
ELAINE CARMELLA MAMOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
15508 W BELL RD, 101-525, SURPRISE, AZ 85374-2432
(623) 584-4746
(623) 584-4750
Mailing address
15508 W BELL RD, 101-525, SURPRISE, AZ 85374-2432
(623) 584-4746
(623) 584-4750
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H04804
AZ
124Q00000X
Dental Hygienist
H05302
AZ
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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