Individual
TRACI SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
6671 US 36, JOES, CO 80822-2321
(719) 343-5152
Mailing address
PO BOX 115, STRATTON, CO 80836-0115
(308) 233-7008
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
002024015
CO
Other
Enumeration date
08/27/2015
Last updated
02/22/2021
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