Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DEN00010699 | CO |
NPI | 1164860581 |
---|---|
Provider Name | Dr. Bryan Limmer |
First Address | Wheat Ridge, CO 80033-4641 |
Second Address | Wheat Ridge, CO 80033-4641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2013 |
Last Update Date | 03/07/2014 |