Individual
EMILY WAIKEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1860 E EGBERT ST, BRIGHTON, CO 80601-2404
(303) 697-2583
Mailing address
804 29TH ST W, BRADENTON, FL 34205-4153
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN00205059
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2021
Last updated
04/16/2022
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