Childress, Kriss L
Childress, Kriss L is an individual health care provider with primary practice located at 1407 West 29Th St , Pueblo CO 81008. He recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as his primary health care specialty. Childress, Kriss L can be contacted via phone (719) 546-0404.Contact Information
Primary practice address
1407 West 29Th St
Pueblo CO 81008
Phone: (719) 546-0404
Fax: (719) 546-0408
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | 3009 | Colorado |
Profile Details
| NPI number | 1881730596 |
|---|---|
| LBN Legal business name | Childress, Kriss L |
| Credentials | Registered Dental Hygienist (RDH) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 29th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881730596 | NPPES |
| Colorado | MEDICAID | 61938742 |
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