Healthcare Provider Details

I. General information

NPI: 1669491940
Provider Name (Legal Business Name): CYNTHIA E. DAFLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 IRIS AVENUE
BOULDER CO
80304-2296
US

IV. Provider business mailing address

1333 IRIS AVENUE
BOULDER CO
80304-2296
US

V. Phone/Fax

Practice location:
  • Phone: 303-443-8500
  • Fax: 303-449-6029
Mailing address:
  • Phone: 303-443-8500
  • Fax: 303-449-6029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35424
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: