Provider Demographics
NPI:1073950465
Name:ENOS, DENISE ANN (RDH)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:ANN
Last Name:ENOS
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 1:1066 VALLEY BUTTE DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7833
Mailing Address - Country:US
Mailing Address - Phone:541-520-9862
Mailing Address - Fax:
Practice Address - Street 1:1066 VALLEY BUTTE DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7833
Practice Address - Country:US
Practice Address - Phone:541-520-9862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-27
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH2845124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist