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NPI Code Detail

MEDICARE: DR. KATHLEEN LOIS BALTZ D.D.S., M.S.

MEDICARE: DR. KATHLEEN LOIS BALTZ D.D.S., M.S.
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
11223E0200XEndodontics9650CO

General Provider Information

NPI Number : 1225228927
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN LOIS BALTZ D.D.S., M.S.
Provider Business Mailing Address
First Line : 7515 W YALE AVE
Second Line : SUITE A
City : DENVER
State : CO
Zip : 80227-3423
Country : US
Telephone Number : 303-691-0891
Fax Number :
Provider Business Practice Location Address
First Line : 7515 W YALE AVE
Second Line : SUITE A
City : DENVER
State : CO
Zip : 80227-3423
Country : US
Telephone Number : 303-691-0891
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2007
Last Update Date : 02/12/2009

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