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General NPI Number Information
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NPI Number | 1134375744
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Entity Type | Individual
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Provider Name | TRAVER LOUIS MAXWELL DMD
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Gender | Male
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 3300 E 1ST AVE STE 500
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City | DENVER
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State | CO
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Zip | 80206-5809
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Country | US
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Telephone | 720-499-1447
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Fax | 720-399-1428
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Provider Business Mailing Address
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Address Line | 195 W TELEGRAPH ST
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City | WASHINGTON
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State | UT
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Zip | 84780-1675
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Country | US
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Telephone | 435-673-4605
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Fax | 435-688-9751
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 9803
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7030242
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License Number State | UT
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