Individual
DR. FRED CARL LAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4857 S BROADWAY, ENGLEWOOD, CO 80113-6806
(303) 761-1340
(303) 783-7176
Mailing address
6162 S. WILLOW DRIVE, SUITE 100, GREENWOOD VILLAGE, CO 80111-5114
(303) 220-9200
(303) 220-9208
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9538
CO
Other
Enumeration date
07/09/2008
Last updated
09/29/2010
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