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Organization

JERRY THALKEN, DDS

Active
Other names
Ray E Lack, DDS
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN BORER (CONSULTANT)
(603) 721-1735
Entity
Organization

Contact information

Practice address
5130 W 80TH AVE, BLDG A STE 200, WESTMINSTER, CO 80030-4450
(303) 429-1426
Mailing address
5130 W 80TH AVE, BLDG A STE 200, WESTMINSTER, CO 80030-4450
(303) 429-1426

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8982
CO

Other

Enumeration date
05/17/2007
Last updated
08/22/2020
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