Provider Demographics
NPI:1972725547
Name:RHOADES, ANGELA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:RHOADES
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 1:520 ZANG ST STE L
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-8235
Mailing Address - Country:US
Mailing Address - Phone:303-665-1281
Mailing Address - Fax:303-464-0705
Practice Address - Street 1:403 SUMMIT BLVD
Practice Address - Street 2:UNIT 202
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-8252
Practice Address - Country:US
Practice Address - Phone:303-665-1281
Practice Address - Fax:303-464-0705
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO904329124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist