Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0004X | Dentist Anesthesiologist | 10727 | CO |
N | 1223D0004X | Dentist Anesthesiologist | 9366 | TN |
NPI | 1063640761 |
---|---|
Provider Name | Dr. Cara Joy Riley |
First Address | Aurora, CO 80045-7106 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2009 |
Last Update Date | 19/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1525983 | (05) | TN |
21106304 | (05) | CO |