Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 2581 | CO |
NPI | 1013452952 |
---|---|
Provider Name | Mrs. Michelle Ann Thornton |
First Address | Denver, CO 80249-8398 |
Second Address | Denver, CO 80249-8398 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2017 |
Last Update Date | 02/01/2017 |