Healthcare Provider Details

I. General information

NPI: 1003297029
Provider Name (Legal Business Name): CLAIRE-MARIE FICSOR DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5590 S WINDERMERE ST SUITE A
LITTLETON CO
80120-1245
US

IV. Provider business mailing address

5590 S WINDERMERE ST SUITE A
LITTLETON CO
80120-1245
US

V. Phone/Fax

Practice location:
  • Phone: 303-798-4571
  • Fax:
Mailing address:
  • Phone: 303-798-4571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberDEN00201899
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN00201899
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. CLAIRE-MARIE FICSOR
Title or Position: CEP
Credential: DMD
Phone: 303-798-4571