Individual
DR. REBECCA FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3494 EAGLE BLVD, BRIGHTON, CO 80601
(303) 659-9543
Mailing address
1249 YORK ST APT 1, DENVER, CO 80206-3082
(818) 425-7510
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DEN.00203525
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/17/2017
Last updated
07/09/2018
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