Provider Demographics
NPI:1023562600
Name:GEISELHOFER LIMITED
Entity Type:Organization
Organization Name:GEISELHOFER LIMITED
Other - Org Name:JENNIFER GEISELHOFER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GEISELHOFER
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:708-650-6229
Mailing Address - Street 1:2205 W 136TH AVE
Mailing Address - Street 2:106-159
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9306
Mailing Address - Country:US
Mailing Address - Phone:708-650-6229
Mailing Address - Fax:720-390-6151
Practice Address - Street 1:2205 W 136TH AVE
Practice Address - Street 2:106-159
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-9306
Practice Address - Country:US
Practice Address - Phone:708-650-6229
Practice Address - Fax:720-390-6151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty