Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 000905970 | CO |
NPI | 1003262718 |
---|---|
Provider Name | Ashley Rangel |
First Address | Denver, CO 80247-3089 |
Second Address | Denver, CO 80247-3089 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2016 |
Last Update Date | 11/05/2016 |