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General NPI Number Information
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NPI Number | 1144230103
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Entity Type | Organization
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Legal Business Name | DENVER WEST DENTAL GROUP
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14062 DENVER WEST PARKWAY #52-120
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City | GOLDEN
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State | CO
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Zip | 80401
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Country | US
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Telephone | 303-279-5050
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Fax | 303-279-1645
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Provider Business Mailing Address
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Address Line | 14062 DENVER WEST PARKWAY #52-120
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City | GOLDEN
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State | CO
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Zip | 80401
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Country | US
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Telephone | 303-279-5050
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Fax | 303-279-1645
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SAM SABURO KAWAKAMI
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Credential | D.D.S.
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Telephone | 303-279-5050
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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 | 4971
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License Number State | CO
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