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Individual

KORY NIEUWKOOP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS, RDH, RDHAP

Contact information

Practice address
23171 ROAD 7, CHOWCHILLA, CA 93610-9204
(559) 706-8741
Mailing address
23171 ROAD 7, CHOWCHILLA, CA 93610-9204
(559) 706-8741

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
30113
CA
124Q00000X
Dental Hygienist
Primary
684
CA
124Q00000X
Dental Hygienist
DH-3275
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12
CA
Enumeration date
08/11/2016
Last updated
11/12/2018
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