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CYNTHIA LYNN PACKARD RDH
>> Dental Hygienist >> Dental ProvidersRegistrant NPI Number: 1679105357
Individual Registrant: CYNTHIA LYNN PACKARD RDH
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
900 CHURCH ST SPRINGFIELD, CO 81073-1636 US
Tel: 719-529-9811 Fax: --
Tel: 719-529-9811 Fax: --
Contact information for business:
PO BOX 193 WALSH, CO 81090-0193 US
Tel: 719-529-9811 Fax: --
Tel: 719-529-9811 Fax: --
Registration Information:
NPI: 1679105357
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 124Q00000X | Dental Providers Dental Hygienist | CO | 202013 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 202013DH | CO | 05 |
