Healthcare Provider Details

I. General information

NPI: 1902988629
Provider Name (Legal Business Name): JOSEPH M CATALANO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 11/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10103 RIDGEGATE PKWY #214
LONETREE CO
80124-5520
US

IV. Provider business mailing address

10103 RIDGEGATE PKWY #214
LONETREE CO
80124-5520
US

V. Phone/Fax

Practice location:
  • Phone: 303-768-8222
  • Fax: 303-225-4733
Mailing address:
  • Phone: 303-768-8222
  • Fax: 303-225-4733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number02074417
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: