Organization
SERENE DENTAL HYGIENE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI JO KINZER RDH (PRESIDENT)
(719) 290-9804
Entity
Organization
Contact information
Practice address
7770 N UNION BLVD, SUITE A, COLORADO SPRINGS, CO 80920-4087
(719) 290-9804
Mailing address
8120 ENGLETON CT, COLORADO SPRINGS, CO 80920-6150
(719) 290-9804
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
DH000902947
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245606268
—
CO
Enumeration date
09/30/2015
Last updated
09/30/2015
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