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Organization

5280 DENTISTRY AND ANESTHESIA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ZACHARY XAVIER VAN HILSEN DDS, MS (OWNER)
(602) 391-8331
Entity
Organization

Contact information

Practice address
2422 GLENARM PL, DENVER, CO 80205-3129
(602) 391-8331
Mailing address
2422 GLENARM PL, DENVER, CO 80205-3129
(602) 391-8331

Taxonomy

Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
DEN.202500
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
13350056
CO
Enumeration date
12/06/2017
Last updated
12/06/2017
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