Individual
MRS. PATRICIA M PINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH,OM
Contact information
Practice address
16422 E CRYSTAL RIDGE DR, FOUNTAIN HILLS, AZ 85268-8415
(847) 207-7463
Mailing address
16422 E CRYSTAL RIDGE DR, FOUNTAIN HILLS, AZ 85268-8415
(847) 207-7463
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
020-004876
IL
124Q00000X
Dental Hygienist
6743-016
WI
124Q00000X
Dental Hygienist
Primary
H4381
AZ
Other
Enumeration date
07/11/2013
Last updated
07/11/2013
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