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General NPI Number Information
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NPI Number | 1548492481
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Entity Type | Individual
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Provider Name | ANDREW JAMES BOCK D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2009
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 1491 DENVER AVE SUITE 102
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City | LOVELAND
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State | CO
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Zip | 80538-5227
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Country | US
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Telephone | 970-669-6670
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Fax | 970-669-6620
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Provider Business Mailing Address
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Address Line | 2781 WHITETAIL CIR
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City | LAFAYETTE
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State | CO
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Zip | 80026-7000
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Country | US
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Telephone | 720-890-5001
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Fax | 720-890-5001
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 9638
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License Number State | CO
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