NPI 1528712775

Mindy Boline, RDH

Practitioner Dental Hygienist Fort Polk, LA

Practice location

Address: 7223 Mississippi Ave, Fort Polk, LA 71459
Phone: (337) 531-2121

Registered specialties

Dental Hygienist Primary

Dental Providers Taxonomy 124Q00000X Licence 008320 (AL)

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Registry record

NPI: 1528712775
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Feb 2022
Record last updated: 7 Feb 2022

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.