Homm, Jacie
Homm, Jacie is an sole proprietor health care provider with primary practice located at 2322 San Juan Ave , La Junta CO 81050-3341. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Homm, Jacie can be contacted via phone (719) 383-3939.Contact Information
Primary practice address
2322 San Juan Ave
La Junta CO 81050-3341
Phone: (719) 383-3939
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | 905307 | Colorado |
Profile Details
| NPI number | 1710142112 |
|---|---|
| LBN Legal business name | Homm, Jacie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 24th, 2008 |
| Last updated | Jul 24th, 2008 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710142112 | NPPES |
| Colorado | MEDICAID | 58300783 |
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