Provider Demographics
NPI:1790237741
Name:RENFRO, SARAH (RDH)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:RENFRO
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 1:1285 CENTAUR VILLAGE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-1214
Mailing Address - Country:US
Mailing Address - Phone:720-287-2614
Mailing Address - Fax:
Practice Address - Street 1:1285 CENTAUR VILLAGE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-1214
Practice Address - Country:US
Practice Address - Phone:720-287-2614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.000905374124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist