Dr. Timothy J. Wachuta
Health Maintenance Organization in Denver, CO. Organization (NPI-2).
NPI number1629457635
StatusActive
Last updated in NPPESMay 22, 2015
Details
- NPI
- 1629457635
- Entity type
- Organization (NPI-2)
- Legal business name
- Dr. Timothy J. Wachuta
- Organization subpart
- No
- Enumeration date
- May 22, 2015
- Last updated
- May 22, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302R00000X | Health Maintenance Organization | 7007 | CO | Yes |
| 302F00000X | Exclusive Provider Organization | 7007 | CO |
Practice location
2709 S. Colorado Blvd.Denver, CO 80222
Phone 303-756-2770 · Fax 303-758-5705
Mailing address
2709 S Colorado BlvdDenver, CO 80222-6601
Phone 303-756-2770 · Fax 303-758-5705
Authorized official
Timothy John Wachuta
Dentist/Owner
3036389440
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