Individual
JOHN A SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2525 28TH ST UNIT 140, BOULDER, CO 80301-1255
(303) 443-0070
(303) 443-0073
Mailing address
PO BOX 245, NIWOT, CO 80544-0245
(303) 443-0070
(303) 430-0073
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
100929
CO
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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