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General NPI Number Information
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NPI Number | 1346946589
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Entity Type | Organization
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Legal Business Name | ARVADA IMPLANTS AND COSMETIC DENTISTRY PC
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 5169 W 64TH AVE
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City | ARVADA
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State | CO
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Zip | 80003
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Country | US
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Telephone | 720-347-1162
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Fax |
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Provider Business Mailing Address
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Address Line | 15111 PRAIRIE PL
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City | BROOMFIELD
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State | CO
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Zip | 80023
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Country | US
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Telephone | 720-347-1162
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | TARIQ SAWAQED
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Credential | DDS
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Telephone | 720-347-1162
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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 |
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License Number State |
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