Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DEN.00201976 | CO |
NPI | 1093156077 |
---|---|
Provider Name | Dr. Dennis Eric Waguespack |
First Address | Denver, CO 80231-4952 |
Second Address | Denver, CO 80231-4952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2013 |
Last Update Date | 08/07/2013 |