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General NPI Number Information
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NPI Number | 1992882567
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER R SPROUT, DDS PC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 25918 GENESEE TRAIL RD SUITE 210
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City | GOLDEN
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State | CO
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Zip | 80401
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Country | US
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Telephone | 303-526-9155
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Fax | 303-526-9277
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Provider Business Mailing Address
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Address Line | 25918 GENESEE TRAIL RD SUITE 210
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City | GOLDEN
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State | CO
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Zip | 80401
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Country | US
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Telephone | 303-526-9155
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Fax | 303-526-9277
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. DIANE M KENDRA
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Credential |
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Telephone | 303-526-9155
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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 | 8660
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License Number State | CO
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