Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 905222 | CO |
NPI | 1013474931 |
---|---|
Provider Name | Ruzanna Levy |
First Address | Aurora, CO 80247-3530 |
Second Address | Aurora, CO 80247-3530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2019 |
Last Update Date | 27/02/2019 |