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1821496001
ARIELLE ILLIA
ROSEBURG, OR
NPI
1821496001
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
124Q00000X Dental Hygienist
(Licence: OR H6899)
Enumeration Date
2014-12-19
Last Update Date
2018-03-17
Business Address
ARIELLE ILLIA
150 NE KENNETH FORD DR
ROSEBURG, OR 97470-1042
Phone number: 541-672-9596
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Mailing Address
ARIELLE ILLIA
150 NE KENNETH FORD DR
ROSEBURG, OR 97470-1042
Phone number: 541-672-9596
Copy
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