Individual
KELLY ELIZABETH HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3617 S PACIFIC HWY, MEDFORD, OR 97501-8957
(541) 535-6239
(541) 512-3178
Mailing address
3617 S PACIFIC HIGHWAY, MEDFORD, OR 97501
(541) 535-6239
(541) 512-3178
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5762
OR
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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