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General NPI Number Information
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NPI Number | 1437901295
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Entity Type | Organization
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Legal Business Name | RIVER VALLEY DENTAL HYGIENE, LLC
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Dates
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Enumeration Date | 04/04/2024
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 317 W 3RD ST, STE 103
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City | LA JUNTA
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State | CO
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Zip | 81050
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Country | US
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Telephone | 719-470-0745
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Fax |
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Provider Business Mailing Address
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Address Line | 317 W 3RD ST, STE 103
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City | LA JUNTA
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State | CO
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Zip | 81050
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Country | US
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Telephone | 719-469-8488
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LENNON TOTTEN
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Credential |
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Telephone | 719-469-8488
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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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