MEDICARE: CHRISTINA PAMATIAN RHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	DH4087	NM

General Provider Information

NPI Number	:	1134696503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA PAMATIAN RHD

Provider Business Mailing Address
First Line	:	8950 E LOWRY BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80230-7030
Country	:	US
Telephone Number	:	303-912-7193
Fax Number	:

Provider Business Practice Location Address
First Line	:	904 LAS LOMAS RD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-2633
Country	:	US
Telephone Number	:	505-924-2650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2018
Last Update Date	:	10/24/2018

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Directions to “ CHRISTINA PAMATIAN RHD” Practice Location

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