Individual
DR. WAYNE FRANK PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1619 N GREENWOOD ST, SUITE 102, PUEBLO, CO 81003-2644
(719) 542-4546
(719) 542-4548
Mailing address
1619 N GREENWOOD ST, SUITE 102, PUEBLO, CO 81003-2644
(719) 542-4546
(719) 542-4548
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0577
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02005775
—
CO
Enumeration date
06/07/2006
Last updated
07/09/2007
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