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General NPI Number Information
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NPI Number | 1558103903
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Entity Type | Individual
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Provider Name | EKENE AZU
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Gender | Male
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 20250 E SMOKY HILL RD UNIT 5
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City | CENTENNIAL
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State | CO
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Zip | 80015-3118
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Country | US
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Telephone | 303-400-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 2506 NEWARK CT APT 306
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City | AURORA
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State | CO
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Zip | 80010-1438
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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 |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DENDEN.00205989
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License Number State | CO
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