Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | CO |
NPI | 1003426636 |
---|---|
Provider Name | Serena Nichole Aragon |
First Address | Denver, CO 80247-1356 |
Second Address | Denver, CO 80219-4235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2020 |
Last Update Date | 07/08/2020 |