Provider Demographics
NPI:1437231271
Name:DACHSANGVORN, NARISA A (RDH)
Entity Type:Individual
Prefix:MS
First Name:NARISA
Middle Name:A
Last Name:DACHSANGVORN
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 1:1455 SUNSET POINT RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755
Mailing Address - Country:US
Mailing Address - Phone:727-461-1455
Mailing Address - Fax:727-461-1035
Practice Address - Street 1:1455 SUNSET POINT ROAD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755
Practice Address - Country:US
Practice Address - Phone:727-461-1455
Practice Address - Fax:727-461-1035
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH17820124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist