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General NPI Number Information
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NPI Number | 1225156201
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Entity Type | Individual
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Provider Name | ANDREY D NAZAROV DMD, MS
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Gender | Male
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 390 S. DAYTON ST.
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City | DENVER
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State | CO
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Zip | 80247
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Country | US
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Telephone | 720-842-4544
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Fax | 303-755-1979
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Provider Business Mailing Address
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Address Line | 390 S. DAYTON ST.
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City | DENVER
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State | CO
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Zip | 80247
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Country | US
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Telephone | 720-842-4544
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Fax | 303-755-1979
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 8530
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License Number State | CO
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