Provider Demographics
NPI:1720816416
Name:DENTAL HYGIENE PRACTICE OF EDITH ROSALES, RDHAP
Entity type:Organization
Organization Name:DENTAL HYGIENE PRACTICE OF EDITH ROSALES, RDHAP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:RECHEL
Authorized Official - Last Name:ROSALES
Authorized Official - Suffix:
Authorized Official - Credentials:RDHAP
Authorized Official - Phone:949-775-7013
Mailing Address - Street 1:26692 BRIDLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7570
Mailing Address - Country:US
Mailing Address - Phone:949-775-7013
Mailing Address - Fax:
Practice Address - Street 1:26692 BRIDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7570
Practice Address - Country:US
Practice Address - Phone:949-775-7013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty