Healthcare Provider Details

I. General information

NPI: 1750188009
Provider Name (Legal Business Name): CARLIE COATES RATH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2025
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 28TH ST
DENVER CO
80205-3003
US

IV. Provider business mailing address

2002 N VINE ST
DENVER CO
80205-5648
US

V. Phone/Fax

Practice location:
  • Phone: 303-602-6333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH.002026635
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: