MEDICARE: DR. DOUGLAS KAI VORIS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DEN-10550	CO

General Provider Information

NPI Number	:	1407135478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS KAI VORIS DDS

Provider Business Mailing Address
First Line	:	1015 S TAFT HILL RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-4240
Country	:	US
Telephone Number	:	970-582-6034
Fax Number	:	970-980-2143

Provider Business Practice Location Address
First Line	:	1015 S TAFT HILL RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-4240
Country	:	US
Telephone Number	:	970-582-6034
Fax Number	:	970-980-2143

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2011
Last Update Date	:	08/09/2011

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