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General NPI Number Information
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NPI Number | 1750778270
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Entity Type | Organization
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Legal Business Name | DENTAL HYGIENE WELLNESS CLINIC
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 2905 INCA ST 2047
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City | DENVER
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State | CO
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Zip | 80202-1023
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Country | US
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Telephone | 720-456-9050
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Fax |
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Provider Business Mailing Address
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Address Line | 2905 INCA ST 2047
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City | DENVER
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State | CO
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Zip | 80202-1023
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Country | US
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Telephone | 720-456-9050
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Fax |
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Authorized Official
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Title or Position | DENTAL HYGIENIST
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Name | JANKEE H BHATT
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Credential | RDH
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Telephone | 720-456-9050
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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 000906510
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License Number State | CO
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