Healthcare Provider Details

I. General information

NPI: 1982170536
Provider Name (Legal Business Name): ROCKE ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 12/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 S BROADWAY STE 300
LITTLETON CO
80122-2624
US

IV. Provider business mailing address

7720 S BROADWAY STE 300
LITTLETON CO
80122-2624
US

V. Phone/Fax

Practice location:
  • Phone: 303-730-7002
  • Fax: 303-730-7002
Mailing address:
  • Phone: 303-730-7002
  • Fax: 303-730-7002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PAUL ALFRED ROCKE
Title or Position: OWNER/ORTHODONTIST
Credential: DDS
Phone: 303-730-7002