Individual
MRS. DONNA RENEE HETHERINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H
Contact information
Practice address
UNIT 26610, WUEZBURG DENTAL ACTIVITY CREDENTIALS OFFICE, APO AE, NY 09244
(931) 804-3933
Mailing address
USA, RWBAHC DENTAC, 2240 E. WINROW AVE, FORT HUACHUCA, AZ 85613
(520) 533-3144
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
DH 17371
FL
124Q00000X
Dental Hygienist
Primary
DH17371
FL
Other
Enumeration date
08/24/2006
Last updated
02/27/2020
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