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General NPI Number Information
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NPI Number | 1518782788
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Entity Type | Organization
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Legal Business Name | HART DENTAL HYGIENE, PLLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1401 N ELIZABETH ST STE A
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City | PUEBLO
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State | CO
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Zip | 81003-2159
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Country | US
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Telephone | 719-582-4741
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Fax | 719-582-4742
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Provider Business Mailing Address
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Address Line | 1401 N ELIZABETH ST STE A
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City | PUEBLO
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State | CO
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Zip | 81003-2159
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Country | US
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Telephone | 719-582-4741
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Fax | 719-582-4742
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Authorized Official
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Title or Position | OWNER/OPERATIONS MANAGER
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Name | REBECCA HART
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Credential |
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Telephone | 719-582-5957
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #2
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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 | NULL
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