Healthcare Provider Details

I. General information

NPI: 1699145284
Provider Name (Legal Business Name): KELLI ROBYN HOBBS RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2015
Last Update Date: 09/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1557 W 84TH AVE
FEDERAL HEIGHTS CO
80260-4780
US

IV. Provider business mailing address

1557 W 84TH AVE
FEDERAL HEIGHTS CO
80260-4780
US

V. Phone/Fax

Practice location:
  • Phone: 303-426-4860
  • Fax:
Mailing address:
  • Phone: 303-426-4860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number906312
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: