Provider Demographics
NPI:1568141349
Name:WHOLE SMILES DENTAL HYGIENE PRACTICE OF ASHLEY HAZELTON, RDHAP
Entity Type:Organization
Organization Name:WHOLE SMILES DENTAL HYGIENE PRACTICE OF ASHLEY HAZELTON, RDHAP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAZELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-458-8010
Mailing Address - Street 1:1840 SHAW AVE STE 105-11
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-4078
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3078 N APRICOT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-9100
Practice Address - Country:US
Practice Address - Phone:559-458-8010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty