MEDICARE: DR. COLIN THOMAS HIRSCH 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	00205312	CO

General Provider Information

NPI Number	:	1962920801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLIN THOMAS HIRSCH DDS

Provider Business Mailing Address
First Line	:	905 W 124TH AVE STE 120
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80234-1718
Country	:	US
Telephone Number	:	630-677-7501
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 W 124TH AVE STE 120
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80234-1718
Country	:	US
Telephone Number	:	303-255-3880
Fax Number	:

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

Provider Enumeration Date	:	08/30/2017
Last Update Date	:	12/10/2023

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