MEDICARE: CLAUDIA P COLORADO 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	7171	AZ
2	1223E0200X	Endodontics	7171D	AZ

General Provider Information

NPI Number	:	1649313313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA P COLORADO DDS

Provider Business Mailing Address
First Line	:	6452 E CARONDELET DR STE 150
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-2213
Country	:	US
Telephone Number	:	520-296-3000
Fax Number	:	928-782-2212

Provider Business Practice Location Address
First Line	:	6452 E CARONDELET DR STE 150
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-2213
Country	:	US
Telephone Number	:	520-296-3000
Fax Number	:	928-782-2212

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	10/16/2018

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