Dominoe Nichole Banuelos, DH
Dental Hygienist in Denver, CO. Individual provider (NPI-1).
NPI number1255816807
StatusActive
Last updated in NPPESSep 29, 2018
Details
- NPI
- 1255816807
- Entity type
- Individual (NPI-1)
- Name
- Dominoe Nichole Banuelos
- Credential
- DH
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 29, 2018
- Last updated
- Sep 29, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 124Q00000X | Dental Hygienist | 002025261 | CO | Yes |
Practice location
3705 E Colfax Ave Unit 101Denver, CO 80206-1810
Phone 303-399-3001
Mailing address
18159 E 44th AveDenver, CO 80249-7602
Phone 303-669-0624
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