Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 8270 | CO |
NPI | 1003911504 |
---|---|
Provider Name | Jodi Lampert |
First Address | Centennial, CO 80122-4005 |
Second Address | Centennial, CO 80122-4005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 08/07/2007 |