MEDICARE: TONYA EPPERLY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	905005	CO

General Provider Information

NPI Number	:	1417169400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA EPPERLY

Provider Business Mailing Address
First Line	:	6160 FIRESTONE BLVD
Second Line	:	STE 105
City	:	FIRESTONE
State	:	CO
Zip	:	80504-6427
Country	:	US
Telephone Number	:	303-532-3371
Fax Number	:

Provider Business Practice Location Address
First Line	:	6160 FIRESTONE BLVD
Second Line	:	STE 105
City	:	FIRESTONE
State	:	CO
Zip	:	80504-6427
Country	:	US
Telephone Number	:	303-532-3371
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	07/08/2007

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Directions to “ TONYA EPPERLY ” Practice Location

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