Provider Demographics
NPI:1346445814
Name:CANDIANO, CAROLYN JANE (RDH)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:JANE
Last Name:CANDIANO
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 1:826 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342
Mailing Address - Country:US
Mailing Address - Phone:219-942-6237
Mailing Address - Fax:219-942-4036
Practice Address - Street 1:1005 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342
Practice Address - Country:US
Practice Address - Phone:219-942-4858
Practice Address - Fax:219-942-4036
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN13005699A124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist