Individual
SANDRA LYNN COTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1270 KOT-NUM ROAD, WARM SPRINGS, OR 97761
(541) 553-2462
Mailing address
292 NW MONTE VISTA AVE, MADRAS, OR 97741-9186
(541) 678-3403
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H3303
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H3303
OREGON BOARD OF DENTISTRY, DENTAL HYGIENE LICENSE
OR
Enumeration date
08/11/2022
Last updated
08/11/2022
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