Healthcare Provider Details

I. General information

NPI: 1255939963
Provider Name (Legal Business Name): ROCKY MOUNTAIN YOUTH MEDICAL AND NURSING CONSULTANTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 10/14/2020
Certification Date: 10/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 S POTOMAC ST STE 130
AURORA CO
80012-5442
US

IV. Provider business mailing address

9197 GRANT ST STE 100
THORNTON CO
80229-4331
US

V. Phone/Fax

Practice location:
  • Phone: 303-360-8111
  • Fax: 303-360-8088
Mailing address:
  • Phone: 303-450-3690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BARBARA TAFOYA
Title or Position: FINANCE ADMINISTRATOR
Credential:
Phone: 303-450-3690