MEDICARE: DR. HAN S. PYO DMD

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	761	CO

General Provider Information

NPI Number	:	1992910426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAN S. PYO DMD

Provider Business Mailing Address
First Line	:	12393 E CORNELL AVE
Second Line	:	SUITE NUMBER 2
City	:	AURORA
State	:	CO
Zip	:	80014-3323
Country	:	US
Telephone Number	:	303-755-1168
Fax Number	:

Provider Business Practice Location Address
First Line	:	12393 E CORNELL AVE
Second Line	:	SUITE NUMBER 2
City	:	AURORA
State	:	CO
Zip	:	80014-3323
Country	:	US
Telephone Number	:	303-755-1168
Fax Number	:

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/08/2007

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