Most Relevant Information
Provider Data
| NPI Number: | 1003575507 |
| Provider Name: | TONYA LANGE |
| Entity Type: | Individual |
| Taxonomy Code: | 124Q00000X |
| Specialty: | Dental Hygienist |
| License Number: | DH.002025877 |
Most Important Dates
| Enumeration Date: | 12/12/2021 |
| Last Updated: | 12/12/2021 |
Provider Practice Location
100 S RIDGE ST STE 103
BRECKENRIDGE
CO
804246498
Practice Location Phone/Fax
| Phone: | 9704539615 |
| Fax: |
Provider Mailing Location
PO BOX 353
ALMA
CO
804200353
Provider Mailing Phone/Fax
| Phone: | 3207616892 |
| Fax: |