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Individual

MRS. MARY HILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
5430 TUTT BLVD, COLORADO SPRINGS, CO 80922-2515
(719) 380-0141
Mailing address
5430 TUTT BLVD, COLORADO SPRINGS, CO 80922-2515
(719) 380-0141

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
002023800
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002023800
RDH
CO
Enumeration date
11/13/2020
Last updated
11/13/2020
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