Individual
KENNETH VAUGHN WADSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11290 W ALAMEDA AVE, #205, LAKEWOOD, CO 80226-2576
(303) 985-9850
(303) 985-5827
Mailing address
5088 S PERRY PARK RD, SEDALIA, CO 80135-8209
(303) 681-3681
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
805
CO
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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