Organization
LEGACY ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WADE HIRSCHMAN (OWNER/DENTIST)
(303) 526-1502
Entity
Organization
Contact information
Practice address
400 INDIANA ST, SUITE 370, GOLDEN, CO 80401-5027
(303) 526-1502
(303) 526-1502
Mailing address
400 INDIANA ST, SUITE 370, GOLDEN, CO 80401-5027
(303) 526-1502
(303) 526-1502
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
9779
CO
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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