Healthcare Provider Details

I. General information

NPI: 1740108570
Provider Name (Legal Business Name): YOUSEF TAHA YOUSEF AMROU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13065 E 17TH AVE
AURORA CO
80045-2505
US

IV. Provider business mailing address

13021 E 21ST AVE
AURORA CO
80045-7454
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-6900
  • Fax:
Mailing address:
  • Phone: 734-757-9053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2951000985
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: