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General NPI Number Information
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NPI Number | 1245470350
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Entity Type | Organization
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Legal Business Name | SHELBY L. KAHL RDH, PC
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 03/02/2009
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Provider Practice Location Address
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Address Line | 1194 W ASH ST STE E
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City | WINDSOR
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State | CO
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Zip | 80550-4608
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Country | US
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Telephone | 970-686-6899
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Fax | 970-686-0889
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Provider Business Mailing Address
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Address Line | 1194 W ASH ST STE E
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City | WINDSOR
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State | CO
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Zip | 80550-4608
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Country | US
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Telephone | 970-686-6899
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Fax | 970-686-0889
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHELBY L KAHL
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Credential | RDH, RMT, CCP
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Telephone | 970-686-6899
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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 | 1848
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License Number State | CO
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