Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 104809 | CO |
NPI | 1083614788 |
---|---|
Provider Name | Dr. David P Noffsinger |
First Address | Grand Junction, CO 81501-6129 |
Second Address | Grand Junction, CO 81501-6129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02048098 | (05) | CO |