Organization
LICENSED DENTAL HYGIENE CARE
Active
Other names
Community Dental health, Senior Mobile Dental, Grand Ave
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. P. MICHELLE VACHA R.D.H. (EXECUTIVE DIRECTOR)
(719) 310-3315
Entity
Organization
Contact information
Practice address
1436 N. HANCOCK AVE, COLORADO SPRINGS, CO 80903
(719) 338-2195
(719) 207-8110
Mailing address
1436 N. HANCOCK AVE, COLORADO SPRINGS, CO 80903
(719) 338-2195
(719) 207-8110
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
20071454175
CO
Other
Enumeration date
09/22/2009
Last updated
12/01/2020
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