Individual
AMY R. TART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4058 WILLOWS RD, ALPINE, CA 91901-1668
(619) 445-1188
Mailing address
1910 TAVERN RD, ALPINE, CA 91901-3126
(619) 722-1270
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
21818
CA
124Q00000X
Dental Hygienist
7055
NC
Other
Enumeration date
02/14/2012
Last updated
02/14/2012
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