Canada Converse, RDH, LAP, BA

NPI #1972898336 in Bandon, Oregon

Provider Information

NPI Number: 1972898336
Entity Type: Individual
Name: Canada Converse, RDH, LAP, BA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dental Hygienist
Credential: RDH, LAP, BA
Enumeration Date: Jun 14, 2011
Last Updated: Jun 14, 2011

Practice Location

Address: 60140 SEVEN DEVILS RD
City: Bandon
State: Oregon
ZIP Code: 97411-7358
Phone: (541) 260-8082

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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