MEDICARE: DR. ANDREW VORONA D.M.D.

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	DN-001987	PA
2	122300000X	Dentist	DS-039789	PA
3	122300000X	Dentist	0401414721	VA
4	122300000X	Dentist	DEN.00203407	CO

General Provider Information

NPI Number	:	1275924151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW VORONA D.M.D.

Provider Business Mailing Address
First Line	:	PO BOX 381
Second Line	:
City	:	WOODLAND PARK
State	:	CO
Zip	:	80866-0381
Country	:	US
Telephone Number	:	609-658-7040
Fax Number	:

Provider Business Practice Location Address
First Line	:	7010 BROADWAY STE 450
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-2946
Country	:	US
Telephone Number	:	609-658-7040
Fax Number	:

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

Provider Enumeration Date	:	02/12/2015
Last Update Date	:	01/08/2018

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