Individual
MRS. KORINE DENISE SUESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
837 S FAIR OAKS AVE, #203, PASADENA, CA 91105-2628
(626) 793-2107
Mailing address
652 ORANGE GROVE AVE, APT B, SOUTH PASADENA, CA 91030-2353
(253) 988-6616
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
22891
CA
124Q00000X
Dental Hygienist
DH00006553
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22891
R.D.H. LICENSE NUMBER
CA
Enumeration date
04/26/2007
Last updated
07/08/2007
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