Most Relevant Information
Provider Data
| NPI Number: | 1003365404 |
| Provider Name: | JACK ALLEN CESSNA RDH, BS |
| Entity Type: | Individual |
| Taxonomy Code: | 124Q00000X |
| Specialty: | Dental Hygienist |
| License Number: | DH.002024533 |
Most Important Dates
| Enumeration Date: | 09/26/2016 |
| Last Updated: | 09/28/2016 |
Provider Practice Location
1006 A ST
GREELEY
CO
806312021
Practice Location Phone/Fax
| Phone: | 9703520048 |
| Fax: |
Provider Mailing Location
2930 11TH AVE
EVANS
CO
806201011
Provider Mailing Phone/Fax
| Phone: | 9703504606 |
| Fax: | 9703504645 |