Provider Demographics
NPI:1568833556
Name:SKELTON, GRETEL (RDH)
Entity Type:Individual
Prefix:
First Name:GRETEL
Middle Name:
Last Name:SKELTON
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 1:3525 W OXFORD AVE # G3
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80236-3106
Mailing Address - Country:US
Mailing Address - Phone:303-797-4260
Mailing Address - Fax:303-797-4266
Practice Address - Street 1:3525 W OXFORD AVE # G3
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80236-3106
Practice Address - Country:US
Practice Address - Phone:303-797-4260
Practice Address - Fax:303-797-4266
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH02023610124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist