MEDICARE: CLAUDE A PAREJA DDS PC

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	0104	CO

General Provider Information

NPI Number	:	1467446187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLAUDE A PAREJA DDS PC

Provider Business Mailing Address
First Line	:	4070 W 72ND AVE
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80030-5210
Country	:	US
Telephone Number	:	303-429-7072
Fax Number	:	303-650-0746

Provider Business Practice Location Address
First Line	:	4070 W 72ND AVE
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80030-5210
Country	:	US
Telephone Number	:	303-429-7072
Fax Number	:	303-650-0746

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CLAUDE A. PAREJA
Credential	:	D.D.S.
Telephone Number	:	303-429-7072

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	10/09/2008

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