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STACEY BAHRE RDH, BS

>> Dental Hygienist >> Dental Providers

Registrant NPI Number: 1578924056

Individual Registrant:
 STACEY  BAHRE RDH, BS
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1332 LINDEN ST SUITE #2 LONGMONT, CO 80501-3257 US
Tel: 303-772-2392  Fax: --

Contact information for business:
1332 LINDEN STREET SUITE #2 LONGMONT, CO 80538 US
Tel: 303-772-2392  Fax: --

Registration Information:
NPI: 1578924056
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y124Q00000XDental Providers
Dental Hygienist
CO002023982
N124Q00000XDental Providers
Dental Hygienist
SDDH1223

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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