Individual
DANESA KHOMENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
210 DIXON AVE, MISSOULA, MT 59801-8722
(406) 370-5024
Mailing address
210 DIXON AVE, MISSOULA, MT 59801-8722
(406) 370-5024
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1119
MT
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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