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Individual

MRS. JOANNA MARIE BOOHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
1825 W KNUDSEN DR STE 220A, PHOENIX, AZ 85027-1377
(623) 299-8799
Mailing address
1825 W KNUDSEN DR # 220A, PHOENIX, AZ 85027-1377

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
H
124Q00000X
Dental Hygienist
Primary
H05418
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01
GOTO SLEEP
Enumeration date
01/11/2019
Last updated
01/11/2019
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