Individual
DR. TODD C DEXTRADEUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
51 W 84TH AVE, STE 300, THORNTON, CO 80260-4883
(303) 777-8333
(303) 777-8338
Mailing address
1324 SOUTH RACE STREET, DENVER, CO 80210
(303) 777-8333
(303) 777-8338
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DR.0035500
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01355007
—
CO
01
—
35500
MEDICAL LICENSE
CO
Enumeration date
05/09/2006
Last updated
10/02/2020
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