Provider Demographics
NPI:1669617957
Name:DOWLING, KRISTEN LEE (RDH, BA, RDHAP)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:LEE
Last Name:DOWLING
Suffix:
Gender:F
Credentials:RDH, BA, RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 WINTERWIND CIR
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-5241
Mailing Address - Country:US
Mailing Address - Phone:925-980-6922
Mailing Address - Fax:
Practice Address - Street 1:332 WINTERWIND CIR
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-5241
Practice Address - Country:US
Practice Address - Phone:925-980-6922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP224124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist