Individual
TIFFANY MAHIKOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, EPDH
Contact information
Practice address
2389 BROOKLYN DR, COOS BAY, OR 97420-1983
(503) 953-4659
Mailing address
2389 BROOKLYN DR, COOS BAY, OR 97420-1983
(503) 953-4659
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6803
OR
Other
Enumeration date
02/05/2016
Last updated
02/05/2016
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