Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 104631 | CO |
NPI | 1154436871 |
---|---|
Provider Name | Dr. James Burquest |
First Address | Centennial, CO 80122-4005 |
Second Address | Centennial, CO 80122-4005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 08/07/2007 |