Individual
MICHELLE CARLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2030 LAKE AVE, PUEBLO, CO 81004-3536
(719) 543-8718
Mailing address
2030 LAKE AVE, PUEBLO, CO 81004-3536
(719) 543-8718
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH000903405
CO
Other
Enumeration date
08/01/2014
Last updated
08/01/2014
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