Individual
DENNIS DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1300 DEXTER ST, FORT LUPTON, CO 80621-1501
(303) 857-0136
Mailing address
1300 DEXTER ST, FORT LUPTON, CO 80621-1501
(303) 857-0136
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHA.0024298
CO
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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