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NPI 1699036715

NPI 1699036715 : DENNIS EDMUND PAIGE CSFA : AURORA, CO

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General NPI Number Information
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    NPI Number           |    1699036715
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    Entity Type          |    Individual 
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    Provider Name        |    DENNIS EDMUND PAIGE CSFA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/05/2012
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    Last Update Date     |    08/19/2022
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Provider Practice Location Address
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    Address Line         |    1079 JOLIET ST 
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    City                 |    AURORA
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    State                |    CO
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    Zip                  |    80010-4047
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    Country              |    US
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    Telephone            |    303-815-4708
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1079 JOLIET ST 
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    City                 |    AURORA
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    State                |    CO
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    Zip                  |    80010-4047
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    Country              |    US
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    Telephone            |    303-815-4708
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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        |    363AS0400X
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    Taxonomy Name        |    Surgical Physician Assistant
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    License Number       |    
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    License Number State |    
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