Healthcare Provider Details

I. General information

NPI: 1750559985
Provider Name (Legal Business Name): LIA D. BAROS D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3538 W 44TH AVE
DENVER CO
80211-1314
US

IV. Provider business mailing address

3538 W 44TH AVE
DENVER CO
80211-1314
US

V. Phone/Fax

Practice location:
  • Phone: 303-433-7500
  • Fax:
Mailing address:
  • Phone: 303-433-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDEN8657
License Number StateCO

VIII. Authorized Official

Name: DR. LIA DARLENE BAROS
Title or Position: ORTHODONTIST
Credential:
Phone: 303-433-7500