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General NPI Number Information
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NPI Number | 1194079343
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Entity Type | Organization
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Legal Business Name | DAVID T. GARLOCK, D.M.D., M.S., P.C.
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Dates
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Enumeration Date | 11/08/2012
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Last Update Date | 11/08/2012
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Provider Practice Location Address
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Address Line | 6020 S GUN CLUB RD UNIT E1
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City | AURORA
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State | CO
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Zip | 80016-5302
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Country | US
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Telephone | 303-627-6212
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Fax | 303-627-1725
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Provider Business Mailing Address
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Address Line | 6020 S GUN CLUB RD UNIT E1
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City | AURORA
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State | CO
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Zip | 80016-5302
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Country | US
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Telephone | 303-627-6212
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Fax | 303-627-1725
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID TIMOTHY GARLOCK
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Credential | D.M.D
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Telephone | 503-317-4837
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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 | DEN00201873
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License Number State | CO
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