Healthcare Provider Details

I. General information

NPI: 1255332516
Provider Name (Legal Business Name): DAVID AREL WITZEL DDS MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 S PEORIA ST
AURORA CO
80014-3182
US

IV. Provider business mailing address

2900 S PEORIA ST
AURORA CO
80014-3182
US

V. Phone/Fax

Practice location:
  • Phone: 303-696-6119
  • Fax: 303-750-1374
Mailing address:
  • Phone: 303-696-6119
  • Fax: 303-750-1374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number4402
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: