Healthcare Provider Details

I. General information

NPI: 1730590571
Provider Name (Legal Business Name): CATHY CARNES DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 02/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 DETROIT ST
DENVER CO
80206-4310
US

IV. Provider business mailing address

359 DETROIT ST
DENVER CO
80206-4310
US

V. Phone/Fax

Practice location:
  • Phone: 303-618-4816
  • Fax:
Mailing address:
  • Phone: 303-618-4816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number7517
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: