Provider Demographics
NPI:1518782788
Name:HART DENTAL HYGIENE, PLLC
Entity type:Organization
Organization Name:HART DENTAL HYGIENE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-582-5957
Mailing Address - Street 1:1401 N ELIZABETH ST STE A
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2159
Mailing Address - Country:US
Mailing Address - Phone:719-582-4741
Mailing Address - Fax:719-582-4742
Practice Address - Street 1:1401 N ELIZABETH ST STE A
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2159
Practice Address - Country:US
Practice Address - Phone:719-582-4741
Practice Address - Fax:719-582-4742
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D.I.C.E. GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-21
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No124Q00000XDental ProvidersDental HygienistGroup - Single Specialty