Individual
SUSAN A TAKEMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4840 RIVERBEND RD, SUITE 200, BOULDER, CO 80301-2608
(303) 440-4777
(303) 440-4776
Mailing address
4840 RIVERBEND RD, SUITE 200, BOULDER, CO 80301-2608
(303) 440-4777
(303) 440-4776
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
105103
CO
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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