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General NPI Number Information
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NPI Number | 1356977185
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Entity Type | Organization
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Legal Business Name | DENVER EYE CARE SPECIALISTS
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Dates
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Enumeration Date | 03/12/2020
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 400 MARSHALL RD
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City | SUPERIOR
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State | CO
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Zip | 80027-8623
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Country | US
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Telephone | 678-770-8649
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Fax |
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Provider Business Mailing Address
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Address Line | 3453 ULSTER ST
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City | DENVER
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State | CO
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Zip | 80238-2784
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OD
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Name | ELINA KOLESNIKOV DAVIDOFF
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Credential |
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Telephone | 678-770-8649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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