Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 8646 | CO |
NPI | 1104914365 |
---|---|
Provider Name | Dr. Demetrios Syrpes |
First Address | Centennial, CO 80112-3837 |
Second Address | Centennial, CO 80112-3837 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 01/05/2012 |