Individual
STACI RENE COBERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1203 D ST, SALIDA, CO 81201-2742
(785) 443-1707
Mailing address
1203 D ST, SALIDA, CO 81201-2742
(785) 443-1707
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH.000904674
CO
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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