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Organization

SUSAN SHADA RDH, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SUSAN MARIE SHADA RDH (OWNER)
(303) 358-6092
Entity
Organization

Contact information

Practice address
9197 GRANT ST, THORNTON, CO 80229-4361
(303) 358-6092
Mailing address
11470 PARIS ST, HENDERSON, CO 80640-7614
(303) 358-6092

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
903675
CO

Other

Enumeration date
03/11/2009
Last updated
03/11/2009
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