Individual
TARA EDEN VANDERPOOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
15182 N 75TH AVE, SUITE 120, PEORIA, AZ 85381-4722
(623) 878-2400
(623) 878-3151
Mailing address
6601 S RURAL RD, TEMPE, AZ 85283-3747
(480) 451-0821
(480) 831-0563
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H007396
AZ
Other
Enumeration date
11/16/2012
Last updated
11/16/2012
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