Individual
JANTIL MARIA SALCIDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
421 WALNUT ST, LA JARA, CO 81140-5064
(719) 274-8948
(719) 274-8920
Mailing address
128 MARKET ST, ALAMOSA, CO 81101-2290
(719) 587-1001
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2026503
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2026503
LICENSE NUMBER
CO
Enumeration date
06/27/2022
Last updated
06/27/2022
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