Healthcare Provider Details

I. General information

NPI: 1720208689
Provider Name (Legal Business Name): SANDRA LOUISE HINTON RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22651 E AURORA PKWY UNIT A5 EAGLE BEND MARKETPLACE
AURORA CO
80016-6086
US

IV. Provider business mailing address

8258 S SICILY CT
AURORA CO
80016-7196
US

V. Phone/Fax

Practice location:
  • Phone: 303-617-0303
  • Fax: 303-617-0603
Mailing address:
  • Phone: 303-362-0504
  • Fax: 303-362-0504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2244
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: