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General NPI Number Information
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NPI Number | 1619961844
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Entity Type | Organization
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Legal Business Name | POULOS & SOMERS PC
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 03/11/2010
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Provider Practice Location Address
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Address Line | 700 BROADWAY STE 1135
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City | DENVER
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State | CO
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Zip | 80203-3421
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Country | US
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Telephone | 303-832-4867
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Fax | 303-861-7267
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Provider Business Mailing Address
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Address Line | 700 BROADWAY STE 1135
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City | DENVER
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State | CO
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Zip | 80203-3421
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Country | US
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Telephone | 303-832-4867
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Fax | 303-861-7267
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANN SOMERS
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Credential | DDS, MS
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Telephone | 303-832-4867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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