Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 8231 | CO |
NPI | 1114025160 |
---|---|
Provider Name | Dr. Neil Neugeboren |
First Address | Denver, CO 80237-1808 |
Second Address | Denver, CO 80231-5500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 05/11/2015 |