Organization
DR. TIMOTHY J. WACHUTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY JOHN WACHUTA DDS (DENTIST/OWNER)
(303) 638-9440
Entity
Organization
Contact information
Practice address
2709 S. COLORADO BLVD., DENVER, CO 80222
(303) 756-2770
(303) 758-5705
Mailing address
2709 S COLORADO BLVD, DENVER, CO 80222-6601
(303) 756-2770
(303) 758-5705
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
7007
CO
302R00000X
Health Maintenance Organization
Primary
7007
CO
Other
Enumeration date
05/22/2015
Last updated
05/22/2015
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