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General NPI Number Information
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NPI Number | 1083719298
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Entity Type | Individual
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Provider Name | JENNIFER THOMASINA LANGEL RDH
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Gender | Female
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 64 MAIN ST
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City | RED FEATHER LAKES
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State | CO
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Zip | 80545
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Country | US
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Telephone | 970-881-2007
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Fax | 970-416-1072
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Provider Business Mailing Address
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Address Line | PO BOX 43 64 MAIN ST RED FEATHER DENTAL CARE
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City | RED FEATHER LAKES
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State | CO
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Zip | 80545
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Country | US
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Telephone | 970-881-2007
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Fax | 970-416-1072
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2963
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License Number State | CO
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