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General NPI Number Information
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NPI Number | 1336574615
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Entity Type | Organization
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Legal Business Name | DAY DREAM DENTAL CARE
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Dates
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Enumeration Date | 09/05/2013
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Last Update Date | 09/05/2013
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Provider Practice Location Address
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Address Line | 7820 INVERNESS BLVD E UNIT 203
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City | ENGLEWOOD
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State | CO
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Zip | 80112-5713
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Country | US
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Telephone | 720-469-8113
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Fax |
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Provider Business Mailing Address
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Address Line | 7820 INVERNESS BLVD E UNIT 203
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City | ENGLEWOOD
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State | CO
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Zip | 80112-5713
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Country | US
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Telephone | 720-469-8113
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. ANDREW B WEISENFELD
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Credential | D.D.S.
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Telephone | 303-332-7725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 104815
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License Number State | CO
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