MEDICARE: RICHARD E FUHR 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	1223G0001X	General Practice Dentistry	104675	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	104675	OTHER	CO	COLORADO LICENSE

General Provider Information

NPI Number	:	1649279464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD E FUHR DDS

Provider Business Mailing Address
First Line	:	8795 RALSTON RD
Second Line	:	#104
City	:	ARVADA
State	:	CO
Zip	:	80002-2364
Country	:	US
Telephone Number	:	303-424-2222
Fax Number	:	303-423-2066

Provider Business Practice Location Address
First Line	:	8795 RALSTON RD
Second Line	:	#104
City	:	ARVADA
State	:	CO
Zip	:	80002-2364
Country	:	US
Telephone Number	:	303-424-2222
Fax Number	:	303-423-2066

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	07/08/2007

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