Individual
ANGELA SAMPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH,BS
Contact information
Practice address
333 LAWS AVE, UKIAH, CA 95482-6540
(707) 468-1010
Mailing address
2970 31ST ST, SACRAMENTO, CA 95817-2726
(313) 737-4487
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
27933
CA
Other
Enumeration date
07/30/2015
Last updated
07/30/2015
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