Individual
DR. REBECCA PAUL IVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
121 N 6TH ST, CANON CITY, CO 81212-3329
(719) 275-2301
Mailing address
121 N 6TH ST, CANON CITY, CO 81212-3329
(719) 275-2301
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00204422
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2018
Last updated
09/29/2020
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