MEDICARE: DR. MATTHEW RAY ROLFSON 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	8006	CO

General Provider Information

NPI Number	:	1942218870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW RAY ROLFSON DDS

Provider Business Mailing Address
First Line	:	250 MAX DR
Second Line	:	STE 203
City	:	CASTLE PINES
State	:	CO
Zip	:	80108-9517
Country	:	US
Telephone Number	:	303-660-0782
Fax Number	:	303-660-0824

Provider Business Practice Location Address
First Line	:	250 MAX DR
Second Line	:	STE 203
City	:	CASTLE PINES
State	:	CO
Zip	:	80108-9517
Country	:	US
Telephone Number	:	303-660-0782
Fax Number	:	303-660-0824

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/18/2016

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