Individual
MIA R FAIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
4406 KUBOTA LN, PASCO, WA 99301-9561
(509) 727-3535
Mailing address
4406 KUBOTA LN, PASCO, WA 99301-9561
(509) 727-3535
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH00007998
WA
Other
Enumeration date
01/30/2025
Last updated
01/30/2025
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