Provider Demographics
NPI:1659123180
Name:MODERN SMILES DENTAL HYGIENE
Entity Type:Organization
Organization Name:MODERN SMILES DENTAL HYGIENE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DENTAL HYGIENIST
Authorized Official - Prefix:
Authorized Official - First Name:HELVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALGADO
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:970-456-2596
Mailing Address - Street 1:PO BOX 1110
Mailing Address - Street 2:
Mailing Address - City:SILT
Mailing Address - State:CO
Mailing Address - Zip Code:81652-1110
Mailing Address - Country:US
Mailing Address - Phone:970-456-2596
Mailing Address - Fax:
Practice Address - Street 1:127 W 3RD ST
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650-2203
Practice Address - Country:US
Practice Address - Phone:970-456-2596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty