Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 35110 | TX |
NPI | 1023465473 |
---|---|
Provider Name | Dr. Colby Cajero |
First Address | Dallas, TX 75218-3453 |
Second Address | Dallas, TX 75218-3453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2016 |
Last Update Date | 23/06/2020 |