Individual
DR. DOMINIC S ITALIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
899 US HIGHWAY 287 STE 600, BROOMFIELD, CO 80020-7319
(303) 460-9366
Mailing address
899 US HIGHWAY 287 STE 600, BROOMFIELD, CO 80020-7319
(303) 460-9366
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00205662
CO
Other
Enumeration date
06/06/2023
Last updated
02/13/2024
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