Individual
MARISSA HIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1087 FOREST DR, SUMMERVILLE, PA 15864-3515
(814) 297-2231
Mailing address
1087 FOREST DR, SUMMERVILLE, PA 15864-3515
(814) 297-2231
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH072025
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1035705460001
—
PA
Enumeration date
11/12/2018
Last updated
06/09/2025
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