Individual
AUGUST DENICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2825 STOCKYARD RD STE I-200, MISSOULA, MT 59808-1548
(406) 728-8420
(406) 541-8430
Mailing address
11600 W 2ND PL, LAKEWOOD, CO 80228-1527
(720) 321-0000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
DR0053632
CO
207L00000X
Anesthesiology Physician
Primary
MED-PHYS-LIC-60262
MT
207R00000X
Internal Medicine Physician
MT196857
PA
Other
Enumeration date
04/22/2010
Last updated
07/21/2022
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