Individual
MICHELLE QADI EL IDRISSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENEIST
Contact information
Practice address
1860 E EGBERT ST, BRIGHTON, CO 80601-2475
(303) 659-4000
(303) 659-9306
Mailing address
203 S ROLLIE AVE, FORT LUPTON, CO 80621-1508
(303) 286-4560
(303) 286-4589
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
906141
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
906141
CO LICENSE
CO
Enumeration date
09/16/2010
Last updated
09/16/2010
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