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General NPI Number Information
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NPI Number | 1114207008
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Entity Type | Organization
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Legal Business Name | GARY D DIXON DDS PLLC
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Dates
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Enumeration Date | 08/23/2011
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Last Update Date | 07/08/2014
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Provider Practice Location Address
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Address Line | 9910 WADSWORTH PKWY SUITE 300
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City | WESTMINSTER
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State | CO
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Zip | 80021-6848
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Country | US
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Telephone | 303-430-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 9910 WADSWORTH PKWY SUITE 300
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City | WESTMINSTER
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State | CO
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Zip | 80021-6848
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Country | US
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Telephone | 303-430-4200
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. GARY D DIXON
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Credential | DDS
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Telephone | 303-430-4200
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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 | 10401
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License Number State | CO
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