Individual
TINA WAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HYGIENIST
Contact information
Practice address
13065 E 17TH AVE, AURORA, CO 80045-2532
(303) 724-6809
Mailing address
13065 E 17TH AVE, AURORA, CO 80045-2532
(303) 724-7427
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
000905628
CO
Other
Enumeration date
07/17/2015
Last updated
04/02/2025
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