MEDICARE: TERRY EGERT 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	104416	CO

General Provider Information

NPI Number	:	1891755013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRY EGERT DDS

Provider Business Mailing Address
First Line	:	3955 E EXPOSITION AVE
Second Line	:	#312
City	:	DENVER
State	:	CO
Zip	:	80209-5000
Country	:	US
Telephone Number	:	303-744-3636
Fax Number	:	303-744-3724

Provider Business Practice Location Address
First Line	:	3955 E EXPOSITION AVE
Second Line	:	#312
City	:	DENVER
State	:	CO
Zip	:	80209-5000
Country	:	US
Telephone Number	:	303-744-3636
Fax Number	:	303-744-3724

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	07/08/2007

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Directions to “ TERRY EGERT DDS” Practice Location

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