Individual
TINA HAIRSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
755 SCOTT CIR, HICKAM AFB, HI 96853-5399
(808) 448-6246
Mailing address
755 SCOTT CIR, HICKAM AFB, HI 96853-5399
(808) 448-6246
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH19221
FL
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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