Ellen Mary Fawl, RDH

NPI #1316620990 in Fort Jones, California

Provider Information

NPI Number: 1316620990
Entity Type: Individual
Name: Ellen Mary Fawl, RDH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Hygienist
Credential: RDH
Enumeration Date: Aug 9, 2023
Last Updated: Aug 9, 2023

Practice Location

Address: 9024 SNIKTAW LN
City: Fort Jones
State: California
ZIP Code: 96032-9408
Phone: (530) 468-4470

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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