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General NPI Number Information
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NPI Number | 1649400235
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Entity Type | Individual
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Provider Name | SARA LYNN NOLEN RDH
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Gender | Female
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 11/19/2018
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Provider Practice Location Address
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Address Line | 1735 S PUBLIC RD STE 100
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City | LAFAYETTE
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State | CO
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Zip | 80026-7093
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Country | US
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Telephone | 303-665-3036
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Fax | 720-206-0434
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Provider Business Mailing Address
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Address Line | 504 E MONROE ST
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City | RAPID CITY
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State | SD
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Zip | 57701-1400
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Country | US
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Telephone | 605-721-8919
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Fax | 605-394-5217
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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 | DH1235
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License Number State | SD
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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 | DH.002024123
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License Number State | CO
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