Provider Demographics
NPI:1134476567
Name:DANG, KIM-CUC THI (RDH)
Entity Type:Individual
Prefix:MRS
First Name:KIM-CUC
Middle Name:THI
Last Name:DANG
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9197 GRANT STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229
Mailing Address - Country:US
Mailing Address - Phone:303-360-8111
Mailing Address - Fax:303-360-8088
Practice Address - Street 1:1550 S POTOMAC ST STE 130
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5442
Practice Address - Country:US
Practice Address - Phone:505-867-5025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH002024299124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist