Sandra Rachele Sumner, RDH
Dental Hygienist in Sullivan, MO. Individual provider (NPI-1).
NPI number1154097939
StatusActive
Last updated in NPPESAug 20, 2021
Details
- NPI
- 1154097939
- Entity type
- Individual (NPI-1)
- Name
- Sandra Rachele Sumner
- Credential
- RDH
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 20, 2021
- Certification date
- Aug 20, 2021
- Last updated
- Aug 20, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 124Q00000X | Dental Hygienist | 2021033142 | MO | Yes |
Other names
- Sandra Rachele Pruitt (Former Name)
Practice location
101 Progress PkwySullivan, MO 63080-2359
Phone 844-853-8937
Mailing address
1800 CommunityClinton, MO 64735-8804
Phone 660-885-8131
Other practice locations
1780 Old Highway 50 E Ste 102
Union, MO 63084-3397
Union, MO 63084-3397
Phone 844-853-8937
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