Individual
MR. JACK EDWARD DURAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS LLC
Contact information
Practice address
3601 S CLARKSON ST, #430, ENGLEWOOD, CO 80113-3948
(303) 789-9257
(303) 789-0732
Mailing address
3601 S CLARKSON ST, #430, ENGLEWOOD, CO 80113-3948
(303) 789-9257
(303) 789-0732
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7453
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31976531
—
CO
Enumeration date
11/03/2006
Last updated
07/08/2007
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