Individual
ANNMARIE CHADDIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1632 FLEMMING DR, LONGMONT, CO 80501-1050
(970) 412-4183
Mailing address
1632 FLEMMING DR, LONGMONT, CO 80501-1050
(970) 412-4183
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
000905298
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-3853262
—
CO
Enumeration date
03/13/2019
Last updated
03/13/2019
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