Provider Demographics
NPI:1770738049
Name:ROCCHI, DEBRA FLORENCE
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:FLORENCE
Last Name:ROCCHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 BAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-2146
Mailing Address - Country:US
Mailing Address - Phone:303-875-0105
Mailing Address - Fax:
Practice Address - Street 1:128 BAYLOR DR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-2146
Practice Address - Country:US
Practice Address - Phone:303-875-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-29
Last Update Date:2008-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO903030124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist