Provider Demographics
NPI:1982020384
Name:FOLEY, KRISTINE ELIZABETH (REGISTERED DENTAL HY)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:ELIZABETH
Last Name:FOLEY
Suffix:
Gender:F
Credentials:REGISTERED DENTAL HY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SE DOUGLAS STREET
Mailing Address - Street 2:FAMILY DENTAL,
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365
Mailing Address - Country:US
Mailing Address - Phone:541-265-4221
Mailing Address - Fax:
Practice Address - Street 1:123 SE DOUGLAS STREET
Practice Address - Street 2:FAMILY DENTAL,
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365
Practice Address - Country:US
Practice Address - Phone:541-265-4221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH2343124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist