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General NPI Number Information
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NPI Number | 1124792395
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Entity Type | Individual
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Provider Name | FAWAZ ALDWEESH DDS
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Gender | Male
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 4930 S YOSEMITE ST STE D1B
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-1382
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Country | US
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Telephone | 720-613-3081
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Fax |
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Provider Business Mailing Address
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Address Line | 3445 N SALIDA ST STE 30
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City | AURORA
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State | CO
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Zip | 80011-5000
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Country | US
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Telephone | 303-366-3383
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN.00204780
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License Number State | CO
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