Provider Demographics
NPI:1962784751
Name:HARI, MIROSLAWA GABRIELA (RDH)
Entity type:Individual
Prefix:
First Name:MIROSLAWA
Middle Name:GABRIELA
Last Name:HARI
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 S BOULDER RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1345
Mailing Address - Country:US
Mailing Address - Phone:303-665-8228
Mailing Address - Fax:303-665-8994
Practice Address - Street 1:4155 DARLEY AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6536
Practice Address - Country:US
Practice Address - Phone:303-499-7072
Practice Address - Fax:303-665-8994
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO906374124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist