Individual
NICHOLAS THEODORE GAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
616 S YORK ST, DENVER, CO 80209-4643
(719) 650-9525
Mailing address
616 S YORK ST, DENVER, CO 80209-4643
(719) 650-9525
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00010010
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24509795
—
CO
Enumeration date
08/13/2009
Last updated
12/11/2024
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