Individual
MS. JENNIFER J MYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
195 W 14TH, RIFLE, CO 81650-4716
(970) 625-5200
Mailing address
PO BOX 861, EAGLE, CO 81631-0861
(920) 360-1870
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH.000904961
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124Q00000X
—
CO
Enumeration date
08/13/2018
Last updated
08/13/2018
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