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MARLYN BETANCOURT RDHAP

>> Dental Hygienist >> Dental Providers

Registrant NPI Number: 1790310050

Individual Registrant:
 MARLYN  BETANCOURT RDHAP
Gender: F
Sole Proprietor

Location and contact information for practice:
85529 BRENDA LN  COACHELLA, CA 92236-4004 US
Tel: 760-902-7456  Fax: --

Contact information for business:
1335 PATRICIA AVE  SIMI VALLEY, CA 93065-2812 US
Tel: 760-902-7456  Fax: --

Registration Information:
NPI: 1790310050
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y124Q00000XDental Providers
Dental Hygienist
CA774
N124Q00000XDental Providers
Dental Hygienist
CA22854

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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