Healthcare Provider Details

I. General information

NPI: 1053678300
Provider Name (Legal Business Name): TERENCE A TRINKA O.D. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26689 PLEASANT PARK RD
CONIFER CO
80433-7703
US

IV. Provider business mailing address

26689 PLEASANT PARK RD
CONIFER CO
80433-7703
US

V. Phone/Fax

Practice location:
  • Phone: 303-838-9355
  • Fax: 303-838-9526
Mailing address:
  • Phone: 303-838-9355
  • Fax: 303-838-9526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number1187
License Number StateCO

VIII. Authorized Official

Name: DR. TERENCE A TRINKA
Title or Position: OWNER
Credential: O.D.
Phone: 303-838-9355