Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 30020765 | OH |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 8312 | CO |
N | 204E00000X | Oral & Maxillofacial Surgeon | 39080 | CO |
NPI | 1427158153 |
---|---|
Provider Name | Dr. Eve Bluestein |
First Address | Niwot, CO 80503-8665 |
Second Address | Niwot, CO 80503-8665 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2006 |
Last Update Date | 12/09/2017 |