Healthcare Provider Details
I. General information
NPI: 1336238021
Provider Name (Legal Business Name): ARNOLD FOSTER TAVEL DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
155 COOK ST SUITE# 231
DENVER CO
80206-5325
US
IV. Provider business mailing address
155 COOK ST SUITE# 231
DENVER CO
80206-5325
US
V. Phone/Fax
- Phone: 303-320-6272
- Fax: 303-779-8348
- Phone: 303-320-6272
- Fax: 303-779-8348
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0700X |
| Taxonomy | Prosthodontics |
| License Number | 105796 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: