Individual
SUSAN BOWLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
101 WEST COAST RD., REDWAY, CA 95560-0769
(707) 923-4313
(707) 923-2590
Mailing address
PO BOX 769, REDWAY, CA 95560-0769
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
21385
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235206087
—
CA
Enumeration date
06/01/2018
Last updated
06/01/2018
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