Healthcare Provider Details

I. General information

NPI: 1336306521
Provider Name (Legal Business Name): HAKALA & HAKALA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 E 8TH AVE STE 200
DENVER CO
80220-3715
US

IV. Provider business mailing address

4200 E 8TH AVE STE 200
DENVER CO
80220-3715
US

V. Phone/Fax

Practice location:
  • Phone: 303-321-8967
  • Fax: 303-321-2561
Mailing address:
  • Phone: 303-321-8967
  • Fax: 303-321-2561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6643
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number6643
License Number StateCO

VIII. Authorized Official

Name: DR. CATHERINE HELEN HAKALA
Title or Position: PRESIDENT
Credential: DDS
Phone: 303-321-8967