Individual
MS. DIANA LYNN CARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
141 LANG ST, SAN JUAN BAUTISTA, CA 95045-9400
(831) 623-4585
(831) 623-4350
Mailing address
PO BOX 264, SAN JUAN BAUTISTA, CA 95045-0264
(831) 623-4585
(831) 623-4350
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HAP00135
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167101
DELTA DENTAL BILLING NO.
CA
01
—
H00135-01
DENTI-CAL ID NO
CA
Enumeration date
02/16/2007
Last updated
07/08/2007
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