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Organization

TODD DEXTRADEUR MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TODD C. DEXTRADEUR MD (OWNER/PHYSICIAN)
(720) 289-8184
Entity
Organization

Contact information

Practice address
51 W. 84TH AVE, STE 300, THORNTON, CO 80260-4883
(720) 289-8184
(303) 457-2341
Mailing address
1324 S. RACE STREET, DENVER, CO 80210-2332
(720) 289-8184
(303) 457-2341

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
207RS0012X
Sleep Medicine (Internal Medicine) Physician
35500
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01355007
CO
01
35500
MEDICAL LIC
CO
Enumeration date
03/04/2008
Last updated
10/09/2020
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