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General NPI Number Information
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NPI Number | 1063078996
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Entity Type | Individual
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Provider Name | NATHANIEL CHERTOK DDS
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Gender | Male
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Dates
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Enumeration Date | 05/16/2019
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 8181 ARISTA PL UNIT 140
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City | BROOMFIELD
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State | CO
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Zip | 80021-7918
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Country | US
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Telephone | 303-427-4120
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Fax |
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Provider Business Mailing Address
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Address Line | 8181 ARISTA PL UNIT 140
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City | BROOMFIELD
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State | CO
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Zip | 80021-7918
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Country | US
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Telephone | 303-427-4120
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Fax |
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DEN00205016
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License Number State | CO
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