Individual
CHANNA SOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
798 WEST RD, SEDRO WOOLLEY, WA 98284-9543
(512) 417-0318
Mailing address
798 WEST RD, SEDRO WOOLLEY, WA 98284-9543
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13311
TX
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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