Individual
JEANNETTE PAK-FUGATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
8520 SPRUCE MOUNTAIN RD STE 110, LARKSPUR, CO 80118-1004
(303) 981-8249
Mailing address
1745 CATNAP LN, MONUMENT, CO 80132-6127
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2994
CO
Other
Enumeration date
01/16/2021
Last updated
01/16/2021
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