Individual
KIMBERLY MECHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2357 NE CONNERS AVE STE 210, BEND, OR 97701-7427
(541) 389-3073
Mailing address
400 SW BOND ST, BEND, OR 97702-3798
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5094
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270364023
—
OR
Enumeration date
11/05/2015
Last updated
05/02/2023
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