Provider Demographics
NPI:1669918736
Name:HARO, CORINA (RDH)
Entity type:Individual
Prefix:
First Name:CORINA
Middle Name:
Last Name:HARO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 CORPORAL EVANS RD
Mailing Address - Street 2:POM DENTAL CLINIC
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93944-3403
Mailing Address - Country:US
Mailing Address - Phone:831-242-5612
Mailing Address - Fax:
Practice Address - Street 1:423 CORPORAL EVANS RD
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93944-3403
Practice Address - Country:US
Practice Address - Phone:831-242-5612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDH30696124Q00000X
TX13151124Q00000X
NMDH2932124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist