MEDICARE: DR. MARY JOYCE SIA UY D.D.S.

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	8022	CO

General Provider Information

NPI Number	:	1457379075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY JOYCE SIA UY D.D.S.

Provider Business Mailing Address
First Line	:	3525 S TAMARAC DR
Second Line	:	SUITE 170
City	:	DENVER
State	:	CO
Zip	:	80237-1419
Country	:	US
Telephone Number	:	303-773-1211
Fax Number	:	303-773-8962

Provider Business Practice Location Address
First Line	:	3525 S TAMARAC DR
Second Line	:	SUITE 170
City	:	DENVER
State	:	CO
Zip	:	80237-1419
Country	:	US
Telephone Number	:	303-773-1211
Fax Number	:	303-773-8962

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/08/2007

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