Individual
CHARLEA DAWN DEROCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
830 W CENTRAL AVE, MISSOULA, MT 59801-7931
(406) 829-9515
(406) 829-9519
Mailing address
830 W CENTRAL AVE, MISSOULA, MT 59801-7931
(406) 829-9515
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DEN-RDH-LIC-21507
MT
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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