Organization
SENIOR SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLGA KOGAN (REGISTERED DENTAL HYGIENIST)
(303) 506-4698
Entity
Organization
Contact information
Practice address
8422 W 78TH CIR, ARVADA, CO 80005-4407
(303) 506-4698
Mailing address
8422 W 78TH CIR, ARVADA, CO 80005-4407
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
000904249
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89689062
—
CO
Enumeration date
10/30/2015
Last updated
10/30/2015
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