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General NPI Number Information
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NPI Number | 1336230408
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Entity Type | Individual
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Provider Name | DONALD ALFRED DECINO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3405 S YARROW ST SUITE A
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City | LAKEWOOD
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State | CO
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Zip | 80227-4965
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Country | US
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Telephone | 303-996-8500
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Fax | 303-996-8501
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Provider Business Mailing Address
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Address Line | 3405 S YARROW ST SUITE A
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City | LAKEWOOD
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State | CO
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Zip | 80227-4965
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Country | US
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Telephone | 303-996-8500
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Fax | 303-996-8501
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 5926
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License Number State | CO
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