Doherty, Cielo Constanza

Doherty, Cielo Constanza is an individual health care provider with primary practice located at Us Hwy 491 North , Shiprock NM 87420. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Doherty, Cielo Constanza can be contacted via phone (505) 368-6401.

Contact Information

Primary practice address
Us Hwy 491 North Shiprock NM 87420
Phone: (505) 368-6401
Fax: (505) 368-6431
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 6891 Colorado

Profile Details

NPI number 1164410882
LBN Legal business name Doherty, Cielo Constanza
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Sep 18th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164410882 NPPES
Colorado MEDICAID 52686264
Colorado MEDICAID B4089
Colorado MEDICAID 618423

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