MEDICARE: DR. CESAR GREGORY MADLANG DDS

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
1	122300000X	Dentist	104022	CO

General Provider Information

NPI Number	:	1265426100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CESAR GREGORY MADLANG DDS

Provider Business Mailing Address
First Line	:	8064 W JEWELL AVE
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80232-6708
Country	:	US
Telephone Number	:	303-985-3624
Fax Number	:	303-985-5527

Provider Business Practice Location Address
First Line	:	8064 W JEWELL AVE
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80232-6708
Country	:	US
Telephone Number	:	303-985-3624
Fax Number	:	303-985-5527

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	07/08/2007

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