Healthcare Provider Details

I. General information

NPI: 1518171933
Provider Name (Legal Business Name): DAVID LOUIS SEWELL D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10083 ASTORBROOK LN
HIGHLANDS RANCH CO
80126-7834
US

IV. Provider business mailing address

1207 DEL REY AVE
PASADENA CA
91107-1405
US

V. Phone/Fax

Practice location:
  • Phone: 303-346-8057
  • Fax:
Mailing address:
  • Phone: 626-365-1187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number58296
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: