Basic Information
| Provider Information | |||||||||
| NPI: | 1669918736 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARO | ||||||||
| FirstName: | CORINA | ||||||||
| MiddleName: | |||||||||
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| Credential: | RDH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 423 CORPORAL EVANS RD | ||||||||
| Address2: | POM DENTAL CLINIC | ||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939443403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8312425612 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 423 CORPORAL EVANS RD | ||||||||
| Address2: | |||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939443403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8312425612 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2017 | ||||||||
| LastUpdateDate: | 01/13/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 124Q00000X | RDH30696 | CA | Y | Dental Providers | Dental Hygienist | 124Q00000X | 13151 | TX | N | Dental Providers | Dental Hygienist | 124Q00000X | DH2932 | NM | N | Dental Providers | Dental Hygienist |
No ID Information.