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General NPI Number Information
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NPI Number | 1144865445
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Entity Type | Individual
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Provider Name | LAURENCE EGGART
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Gender | Male
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Dates
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Enumeration Date | 11/10/2019
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Last Update Date | 11/10/2019
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Provider Practice Location Address
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Address Line | 10650 GARDEN DR UNIT 106
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City | AURORA
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State | CO
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Zip | 80012-7019
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Country | US
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Telephone | 303-366-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 13650 E COLFAX AVE APT 4503
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City | AURORA
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State | CO
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Zip | 80011-7075
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Country | US
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Telephone | 843-446-4667
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN.00203620
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License Number State | CO
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