Most Relevant Information
Provider Data
| NPI Number: | 1003298738 |
| Provider Name: | KIRSTEN TACHA RDH |
| Entity Type: | Individual |
| Taxonomy Code: | 124Q00000X |
| Specialty: | Dental Hygienist |
| License Number: | 903659 |
Most Important Dates
| Enumeration Date: | 06/18/2015 |
| Last Updated: | 04/05/2017 |
Provider Practice Location
820 1ST STREET
LIMON
CO
80828
Practice Location Phone/Fax
| Phone: | 7196325700 |
| Fax: |
Provider Mailing Location
3205 N ACADEMY BLVD
SUITE 130
COLORADO SPRINGS
CO
809175147
Provider Mailing Phone/Fax
| Phone: | 7196325700 |
| Fax: |