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NPI Code Detail

MEDICARE: SEAN OGRADY DMD LLC

MEDICARE: SEAN OGRADY DMD LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry
2122300000XDentist

General Provider Information

NPI Number : 1205427895
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEAN OGRADY DMD LLC
Provider Business Mailing Address
First Line : 4402 UMATILLA ST
Second Line :
City : DENVER
State : CO
Zip : 80211-1534
Country : US
Telephone Number : 720-551-6580
Fax Number : 720-551-6581
Provider Business Practice Location Address
First Line : 4402 UMATILLA ST
Second Line :
City : DENVER
State : CO
Zip : 80211-1534
Country : US
Telephone Number : 720-551-6580
Fax Number : 720-551-6581
Authorized Official
Title or Position : DENTIST/CEO/OWNER
Name : SEAN OGRADY
Credential :
Telephone Number : 720-551-6580
Provider Enumeration Date : 01/27/2021
Last Update Date : 01/27/2021

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Directions to “SEAN OGRADY DMD LLC ” Practice Location

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