MEDICARE: DR THOMAS A FORTI DDS PC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1497791776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR THOMAS A FORTI DDS PC

Provider Business Mailing Address
First Line	:	5959 S UNIVERSITY BLVD
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80121-2835
Country	:	US
Telephone Number	:	303-795-7674
Fax Number	:	303-794-8947

Provider Business Practice Location Address
First Line	:	5959 S UNIVERSITY BLVD
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80121-2835
Country	:	US
Telephone Number	:	303-795-7674
Fax Number	:	303-794-8947

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	MR. THOMAS A FORTI
Credential	:	DDS
Telephone Number	:	303-795-7674

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	08/22/2020

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