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General NPI Number Information
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NPI Number | 1477092500
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Entity Type | Organization
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Legal Business Name | SIGNATURE DENTISTRY OF AURORA
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 13764 E QUINCY AVE
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City | AURORA
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State | CO
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Zip | 80015-1129
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Country | US
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Telephone | 303-423-7298
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Fax |
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Provider Business Mailing Address
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Address Line | 13764 E QUINCY AVE
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City | AURORA
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State | CO
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Zip | 80015-1129
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Country | US
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Telephone | 303-423-7298
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Fax |
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Authorized Official
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Title or Position | PARTNER/OWNER
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Name | DAVID BENNETT
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Credential |
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Telephone | 303-690-0877
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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 | 10483
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7665
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License Number State | CO
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