Individual
DR. JEREMY G CARDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
718 MALETA LN, STE 102, CASTLE ROCK, CO 80108-7602
(303) 814-9899
Mailing address
718 MALETA LN, STE 102, CASTLE ROCK, CO 80108-7602
(303) 814-9899
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DD3475
NM
122300000X
Dentist
Primary
DEN.00202126
CO
1223G0001X
General Practice Dentistry
DE60034302
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE60034302
WASHINGTON STATE DENTAL LICENSE
WA
Enumeration date
07/29/2008
Last updated
12/19/2013
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