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General NPI Number Information
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NPI Number | 1649693383
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Entity Type | Organization
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Legal Business Name | ROGER B. ELTON, D.D.S., P.C.
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Dates
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Enumeration Date | 01/31/2014
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 5657 S HIMALAYA ST STE 110
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City | AURORA
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State | CO
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Zip | 80015-5308
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Country | US
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Telephone | 303-364-6433
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Fax | 303-699-8246
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Provider Business Mailing Address
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Address Line | 5657 S HIMALAYA ST STE 110
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City | AURORA
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State | CO
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Zip | 80015-5308
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Country | US
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Telephone | 303-364-6433
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Fax | 303-699-8246
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROGER B ELTON
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Credential | D.D. S.
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Telephone | 303-364-6433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 192
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License Number State | CO
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