Individual
DR. TERRANCE MICHAEL WOLBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5492 S PARKER RD, AURORA, CO 80015-1136
(303) 766-8811
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 353-9403
(970) 353-9906
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10189
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83630279
—
CO
Enumeration date
06/01/2009
Last updated
06/27/2016
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