Individual
TRACY DEPERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
13065 E 17TH AVE, AURORA, CO 80045-2532
(303) 724-9540
Mailing address
SCHOOL OF DENTAL MEDICINE UNIVERSITY OF COLORADO, 13065 EAST 17TH AVENUE, DENVER, CO 80045-1078
(303) 724-9540
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00204232
CO
1223G0001X
General Practice Dentistry
2901020813
MI
Other
Enumeration date
09/07/2012
Last updated
08/04/2020
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