Provider Demographics
NPI:1023369469
Name:TARIN, EUGENIA G (RDH)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:G
Last Name:TARIN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 910
Mailing Address - Street 2:
Mailing Address - City:CANUTILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79835-0910
Mailing Address - Country:US
Mailing Address - Phone:915-231-4386
Mailing Address - Fax:915-886-9947
Practice Address - Street 1:700 S OCHOA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79901-2936
Practice Address - Country:US
Practice Address - Phone:915-231-4386
Practice Address - Fax:915-886-9947
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17878124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist