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General NPI Number Information
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NPI Number | 1619163219
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Entity Type | Organization
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Legal Business Name | ARISTIDES A TSIKOUDAKIS DMD LLC
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 09/18/2007
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Provider Practice Location Address
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Address Line | 255 UNION BLVD SUITE 440
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City | LAKEWOOD
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State | CO
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Zip | 80228-1810
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Country | US
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Telephone | 303-984-9200
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Fax | 303-984-5646
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Provider Business Mailing Address
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Address Line | 255 UNION BLVD SUITE 440
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City | LAKEWOOD
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State | CO
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Zip | 80228-1810
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Country | US
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Telephone | 303-984-9200
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Fax | 303-984-5646
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. ARISTIDES A TSIKOUDAKIS
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Credential | D.M.D.
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Telephone | 303-984-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 8927
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License Number State | CO
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