MEDICARE: DR. GREGORY RAYMOND WERNER 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	10440	CO

General Provider Information

NPI Number	:	1639440811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY RAYMOND WERNER DDS

Provider Business Mailing Address
First Line	:	8113 W 94TH AVE
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80021-4515
Country	:	US
Telephone Number	:	303-432-9773
Fax Number	:	303-432-9792

Provider Business Practice Location Address
First Line	:	8113 W 94TH AVE
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80021-4515
Country	:	US
Telephone Number	:	303-432-9773
Fax Number	:	303-432-9792

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

Provider Enumeration Date	:	01/20/2012
Last Update Date	:	05/10/2023

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