Provider Demographics
NPI:1477007391
Name:TEMPLETON, JAMMY
Entity Type:Individual
Prefix:
First Name:JAMMY
Middle Name:
Last Name:TEMPLETON
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 1:701 CAMINO DEL RIO STE 316
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5596
Mailing Address - Country:US
Mailing Address - Phone:970-335-2442
Mailing Address - Fax:
Practice Address - Street 1:701 CAMINO DEL RIO STE 316
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5596
Practice Address - Country:US
Practice Address - Phone:970-335-2442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO904985124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist