Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | 130 | OK |
Y | 1223P0221X | Pediatric Dentist | 8176 | CO |
NPI | 1063534857 |
---|---|
Provider Name | Dr. Autumn G Hurd |
First Address | Littleton, CO 80122-2611 |
Second Address | Littleton, CO 80122-2611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 14/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08184275 | (05) | CO |