Organization
TOOTHFAIRY IN HOME DENTAL HYGIENE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONNIE M SLATKIN RDHAP (OWNER)
(925) 788-0235
Entity
Organization
Contact information
Practice address
278 STRANAHAN CIR, CLAYTON, CA 94517-1456
(925) 788-2035
Mailing address
278 STRANAHAN CIR, CLAYTON, CA 94517-1456
(925) 788-2035
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
HAP 490
CA
Other
Enumeration date
02/11/2016
Last updated
02/11/2016
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