Individual
MISS CAROL MARIE JAWORSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
PO BOX PH, CHINLE, AZ 86503-8000
(928) 674-7001
Mailing address
PO BOX PH, CHINLE, AZ 86503-8000
(928) 674-7001
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H01517
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063470870
—
MI
01
—
383518314
TAX ID
MI
01
—
950C9502
BCBS
MI
01
—
P93198
BCN
MI
Enumeration date
05/02/2006
Last updated
10/25/2023
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