MEDICARE: ADRIANA MICHELLE O'CONNOR R.D.H.

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	DH002023884	CO

General Provider Information

NPI Number	:	1497133730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANA MICHELLE O'CONNOR R.D.H.

Provider Business Mailing Address
First Line	:	3327 W 29TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-3609
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3636 W COLFAX AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-1513
Country	:	US
Telephone Number	:	303-592-7253
Fax Number	:

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

Provider Enumeration Date	:	05/06/2015
Last Update Date	:	05/06/2015

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