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General NPI Number Information
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NPI Number | 1023562600
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Entity Type | Organization
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Legal Business Name | GEISELHOFER LIMITED
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Dates
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Enumeration Date | 08/11/2016
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 2205 W 136TH AVE 106-159
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City | BROOMFIELD
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State | CO
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Zip | 80023-9306
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Country | US
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Telephone | 708-650-6229
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Fax | 720-390-6151
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Provider Business Mailing Address
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Address Line | 2205 W 136TH AVE 106-159
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City | BROOMFIELD
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State | CO
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Zip | 80023-9306
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Country | US
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Telephone | 708-650-6229
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Fax | 720-390-6151
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER LYNN GEISELHOFER
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Credential | R.D.H
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Telephone | 708-650-6229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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