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NPI Code Detail

MEDICARE: JULIE CHAMBERLIN RDH

MEDICARE: JULIE CHAMBERLIN RDH
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
1124Q00000XDental Hygienist903490CO

General Provider Information

NPI Number : 1306175872
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE CHAMBERLIN RDH
Provider Business Mailing Address
First Line : 4023 BUTLER LN
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-5055
Country : US
Telephone Number : 970-206-9132
Fax Number : 970-206-9132
Provider Business Practice Location Address
First Line : 4023 BUTLER LN
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-5055
Country : US
Telephone Number : 970-206-9132
Fax Number : 970-206-9132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2009
Last Update Date : 12/13/2009

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