Provider Demographics
NPI:1215254974
Name:DO, TAMMY THI (RDH)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:THI
Last Name:DO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11005 RALSTON RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004
Mailing Address - Country:US
Mailing Address - Phone:303-360-6276
Mailing Address - Fax:303-762-6552
Practice Address - Street 1:11005 RALSTON RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-4551
Practice Address - Country:US
Practice Address - Phone:303-360-6276
Practice Address - Fax:303-762-6552
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO905662124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist