Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 10439 | CO |
NPI | 1033318746 |
---|---|
Provider Name | Jose Roberto Franco |
First Address | Lafayette, CO 80026-2832 |
Second Address | Denver, CO 80221-2721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2007 |
Last Update Date | 17/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
90955536 | (05) | CO |