Provider Demographics
NPI:1326338187
Name:CENTER, MARSHA STORME (RDH, RDHAP)
Entity Type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:STORME
Last Name:CENTER
Suffix:
Gender:F
Credentials:RDH, RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16654 SOLEDAD CANYON RD
Mailing Address - Street 2:#202
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-3217
Mailing Address - Country:US
Mailing Address - Phone:661-298-4720
Mailing Address - Fax:661-298-4720
Practice Address - Street 1:16654 SOLEDAD CANYON RD
Practice Address - Street 2:#202
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-3217
Practice Address - Country:US
Practice Address - Phone:661-298-4720
Practice Address - Fax:661-298-4720
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA312124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist