Provider Demographics
NPI:1821405069
Name:HYGIENE CENTER, LLC
Entity Type:Organization
Organization Name:HYGIENE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:JANKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-994-9693
Mailing Address - Street 1:1316 JACKIE RD SE STE 300
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1045
Mailing Address - Country:US
Mailing Address - Phone:505-994-9693
Mailing Address - Fax:505-891-3169
Practice Address - Street 1:1316 JACKIE RD SE STE 300
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1045
Practice Address - Country:US
Practice Address - Phone:505-994-9693
Practice Address - Fax:505-891-3169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD27801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty