Provider Demographics
NPI:1699902767
Name:CHAMBERS, CYNTHIA MARIE (RDHAP)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:MARIE
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 RAINTREE CIR
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4444
Mailing Address - Country:US
Mailing Address - Phone:310-387-4334
Mailing Address - Fax:
Practice Address - Street 1:1309 RAINTREE CIR
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4444
Practice Address - Country:US
Practice Address - Phone:310-387-4334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7230124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist