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General NPI Number Information
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NPI Number | 1285386342
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Entity Type | Individual
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Provider Name | SHELBY TAGTMEYER DENTAL HYGIENIST
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Gender | Female
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 820 1ST ST
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City | LIMON
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State | CO
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Zip | 80828-5008
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Country | US
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Telephone | 719-344-7185
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Fax |
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Provider Business Mailing Address
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Address Line | 955 5TH ST
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City | BERTHOUD
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State | CO
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Zip | 80513-1182
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Country | US
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Telephone | 970-420-0131
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Fax |
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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.002024390
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License Number State | CO
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