Individual
DR. ANIL JOSEPH IDICULLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
11275 E MISSISSIPPI AVE, SUITE 2-N, AURORA, CO 80012-3263
(303) 341-4878
Mailing address
4550 CHERRY CREEK SOUTH DR, APARTMENT 2200, DENVER, CO 80246-1554
(215) 908-0008
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9309
CO
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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