Organization
REGENTS OF THE UNIVERSITY OF COLORADO
Active
Other names
School of Dental Medicine, Faculty Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN DAVIS MBA,MSHA,CMA (ASSOCIATE DEAN OF FINANCE ADMINISTR)
(303) 724-7132
Entity
Organization
Contact information
Practice address
13065 E 17TH AVE, MAIL STOP F742, AURORA, CO 80045-2532
(303) 724-5509
Mailing address
13065 E 17TH AVE, AURORA, CO 80045-2532
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DR.0055063
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09034528
—
CO
Enumeration date
10/19/2015
Last updated
10/19/2015
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