Healthcare Provider Details

I. General information

NPI: 1043046238
Provider Name (Legal Business Name): MIGUEL BRITO-MARIANI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7015 W 38TH AVE
WHEAT RIDGE CO
80033-4876
US

IV. Provider business mailing address

7015 W 38TH AVE
WHEAT RIDGE CO
80033-4876
US

V. Phone/Fax

Practice location:
  • Phone: 303-940-9755
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1043046238
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: