NPI 1245501808

Holly Ann Daverin, RDH

Practitioner Dental Hygienist Fort Washakie, WY

Practice location

Address: 29 Black Coal Drive Fort Washakie Dental Clinic, Fort Washakie, WY 82514-0128
Phone: (307) 332-7300
Mailing address: 11102 W 4000n Rd, Bonfield, IL 60913-7171

Registered specialties

Dental Hygienist Primary

Dental Providers Taxonomy 124Q00000X Licence H6127 (OR)

Other Dental Hygienist providers in Wyoming →

Registry record

NPI: 1245501808
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Jan 2012
Record last updated: 13 Jan 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.