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General NPI Number Information
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NPI Number | 1194767103
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Entity Type | Individual
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Provider Name | MARIA ANTONIA MCKENZIE RDH
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Gender | Female
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 15132 E HAMPDEN AVE SUITE G
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City | AURORA
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State | CO
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Zip | 80014-5072
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Country | US
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Telephone | 303-762-6546
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Fax | 303-762-6550
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Provider Business Mailing Address
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Address Line | 3701 S BROADWAY
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City | ENGLEWOOD
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State | CO
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Zip | 80115-3611
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Country | US
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Telephone | 303-361-1977
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Fax | 303-761-2787
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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 | DH.000904142
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License Number State | CO
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