Organization
IGNACIO DENTAL HYGIENE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ENA MARIE MILLICH R.D. H. (OWNER)
(970) 563-0373
Entity
Organization
Contact information
Practice address
610 GODDARD, IGNACIO, CO 81137-0785
(970) 563-0373
(970) 563-9037
Mailing address
PO BOX 785, IGNACIO, CO 81137-0785
(970) 563-0373
(970) 563-9037
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
302R00000X
Health Maintenance Organization
2023390
CO
Other
Enumeration date
01/31/2014
Last updated
07/17/2020
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