Provider Demographics
NPI:1184005209
Name:SPAHN, MARGARET
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:SPAHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 COUNTY ROAD 63
Mailing Address - Street 2:
Mailing Address - City:KEENESBURG
Mailing Address - State:CO
Mailing Address - Zip Code:80643-8403
Mailing Address - Country:US
Mailing Address - Phone:720-560-0832
Mailing Address - Fax:
Practice Address - Street 1:435 COUNTY ROAD 63
Practice Address - Street 2:
Practice Address - City:KEENESBURG
Practice Address - State:CO
Practice Address - Zip Code:80643-8403
Practice Address - Country:US
Practice Address - Phone:720-560-0832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3001124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist