Provider Demographics
NPI:1538925748
Name:CANALES NAVARRETE, CAROLE (DH)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:
Last Name:CANALES NAVARRETE
Suffix:
Gender:F
Credentials:DH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 MARTINEZ CT UNIT 104
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-6141
Mailing Address - Country:US
Mailing Address - Phone:929-523-4326
Mailing Address - Fax:
Practice Address - Street 1:164 MARTINEZ CT UNIT 104
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-6141
Practice Address - Country:US
Practice Address - Phone:929-523-4326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH31623124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty