Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH.000903619 | CO |
NPI | 1003284209 |
---|---|
Provider Name | Mrs. Maria Alta Mcvey |
First Address | Golden, CO 80401 |
Second Address | Golden, CO 80401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2015 |
Last Update Date | 04/09/2015 |