Individual
TAMARA BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH MPH
Contact information
Practice address
635 E BASELINE RD, PHOENIX, AZ 85042-6551
(602) 243-7277
Mailing address
714 E TAYLOR ST, TEMPE, AZ 85281-1158
(602) 818-8778
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H04531
AZ
Other
Enumeration date
10/19/2016
Last updated
12/13/2016
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