NPI 1740305549

Shelly Suzanne Raichart, DDS

Practitioner General Practice Dentistry Edwards, CO

Practice location

Address: 0057 Edwards Access Rd Suite 21, Edwards, CO 81632
Phone: (970) 926-1519
Fax: (970) 926-1044
Mailing address: PO Box 1478, Edwards, CO 81632-1478

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 7209 (CO)

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Registry record

NPI: 1740305549
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Mar 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.