=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588708135
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | W. J. GAREHIME P C
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6660 TIMBERLINE RD SUITE 200
-----------------------------------------------------
City | HIGHLANDS RANCH
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80130-5345
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-741-4441
-----------------------------------------------------
Fax | 303-741-8683
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6660 TIMBERLINE RD SUITE 200
-----------------------------------------------------
City | HIGHLANDS RANCH
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80130-5345
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-741-4441
-----------------------------------------------------
Fax | 303-741-8683
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. WILLIAM J GAREHIME
-----------------------------------------------------
Credential | D.D.S.
-----------------------------------------------------
Telephone | 303-741-4441
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223S0112X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
-----------------------------------------------------
License Number | DEN104875
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------