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General NPI Number Information
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NPI Number | 1982052296
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Entity Type | Organization
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Legal Business Name | JEANETTE COURTAD, DDS
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Dates
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Enumeration Date | 05/26/2016
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Last Update Date | 05/26/2016
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Provider Practice Location Address
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Address Line | 623 14TH ST
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City | GOLDEN
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State | CO
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Zip | 80401-1904
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Country | US
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Telephone | 303-279-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 623 14TH ST
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City | GOLDEN
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State | CO
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Zip | 80401-1904
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Country | US
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Telephone | 303-279-5900
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JEANETTE COURTAD
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Credential | DDS
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Telephone | 303-279-5900
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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 | 7442
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License Number State | CO
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