Individual
EDITH VALDEZ DETELLO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1055 CLERMONT ST, DENTAL 160 DEPT OF VETERANS AFFAIRS ECHCS, DENVER, CO 80220
(303) 393-2823
(303) 393-4632
Mailing address
23508 E OHAWA PL, AURORA, CO 80016
(303) 307-9076
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3013
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06000008
VA
CO
Enumeration date
05/10/2006
Last updated
07/08/2007
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