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General NPI Number Information
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NPI Number | 1871992404
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Entity Type | Organization
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Legal Business Name | EGERT-KREIDER DENTAL
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Dates
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Enumeration Date | 08/20/2014
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Last Update Date | 08/20/2014
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Provider Practice Location Address
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Address Line | 3955 E. EXPOSTITION AVE SUITE 312
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City | DENVER
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State | CO
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Zip | 80209
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Country | US
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Telephone | 303-744-3636
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Fax | 303-744-3724
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Provider Business Mailing Address
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Address Line | 3955 E. EXPOSTITION AVE SUITE 312
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City | DENVER
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State | CO
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Zip | 80209
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Country | US
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Telephone | 303-744-3636
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Fax | 303-744-3724
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. TERRY EGERT
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Credential | DDS
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Telephone | 303-744-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | CO
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