Linda A Branch, RDA

Individual provider Active NPI Dental Assistant · Alpine, CA

NPI 1962775429 · NPPES record last updated Feb 14, 2012

Key facts

NPI
1962775429
Entity type
Individual (NPI type 1)
Primary specialty
Dental Assistant 126800000X
License
39447 (CA)
Practice address
4058 Willows Rd
Alpine, CA 91901-1668
Phone
(619) 445-1188
NPI assigned
Feb 14, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
39447CAMDDental Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X 39447 CA Yes

Addresses

Primary practice location

4058 Willows Rd
Alpine, CA 91901-1668

Mailing address

30037 Canvasback Dr
Campo, CA 91906-1455
Phone (619) 838-6712

Other providers in Alpine, CA

All providers in Alpine, CA · Dental Assistant in California

Sources for this page

Verify at the official NPI Registry.