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NPI 1043444128

NPI 1043444128 : DAVID G. SABOTT : BRIGHTON, CO

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General NPI Number Information
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    NPI Number           |    1043444128
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID G. SABOTT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/05/2009
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    Last Update Date     |    05/05/2009
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Provider Practice Location Address
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    Address Line         |    503 S 4TH AVE 
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    City                 |    BRIGHTON
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    State                |    CO
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    Zip                  |    80601-3102
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    Country              |    US
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    Telephone            |    720-682-0153
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    Fax                  |    720-685-3453
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Provider Business Mailing Address
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    Address Line         |    503 S 4TH AVE 
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    City                 |    BRIGHTON
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    State                |    CO
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    Zip                  |    80601-3102
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    Country              |    US
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    Telephone            |    720-682-0153
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    Fax                  |    720-685-3453
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    00515
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    License Number State |    CO
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