Organization
DIVERSIFIED MOBILE SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI HARRIS RDHAP44 (OWNER PRESIDENT)
(510) 227-5804
Entity
Organization
Contact information
Practice address
3016 SAN JOSE AVE, ALAMEDA, CA 94501-4834
(510) 227-5804
(510) 227-5804
Mailing address
1271 WASHINGTON AVE, 810, SAN LEANDRO, CA 94577-3646
(510) 227-5804
(510) 227-5804
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDHAP44
CA
Other
Enumeration date
05/29/2007
Last updated
02/13/2013
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