Provider Demographics
NPI:1083267074
Name:SHEETS FAMILY DENTAL HYGIENE, LLC
Entity Type:Organization
Organization Name:SHEETS FAMILY DENTAL HYGIENE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DENTAL HYGIENIST
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:SHEETS
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:719-491-1696
Mailing Address - Street 1:PO BOX 513
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:CO
Mailing Address - Zip Code:80860-0513
Mailing Address - Country:US
Mailing Address - Phone:719-491-1696
Mailing Address - Fax:
Practice Address - Street 1:807 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:CO
Practice Address - Zip Code:80860-8086
Practice Address - Country:US
Practice Address - Phone:719-491-1696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental