Provider Demographics
NPI:1851612840
Name:CAIRNS, TAMMY (RDH, BS)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:CAIRNS
Suffix:
Gender:F
Credentials:RDH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-3335
Mailing Address - Country:US
Mailing Address - Phone:719-963-5778
Mailing Address - Fax:
Practice Address - Street 1:2192 WILLOW ST
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-3745
Practice Address - Country:US
Practice Address - Phone:719-963-5778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH-905306124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist