Healthcare Provider Details

I. General information

NPI: 1477746105
Provider Name (Legal Business Name): DENVER HEALTH AND HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 12/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST MC 1923
DENVER CO
80204-4507
US

IV. Provider business mailing address

777 BANNOCK ST MC 1923
DENVER CO
80204-4507
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-6000
  • Fax:
Mailing address:
  • Phone: 303-436-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number010444
License Number StateCO

VIII. Authorized Official

Name: PEGGY J BURNETTE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 303-602-4964