Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 104164 | CO |
NPI | 1063854321 |
---|---|
Provider Name | James E Caldwell |
First Address | Hartsel, CO 80449-8611 |
Second Address | Fairplay, CO 80440 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2013 |
Last Update Date | 14/08/2018 |