Loscar Numael Perez, DMD

Individual provider Active NPI Prosthodontics · Durango, CO

NPI 1669665485 · NPPES record last updated Nov 2, 2014

Key facts

NPI
1669665485
Entity type
Individual (NPI type 1)
Primary specialty
Prosthodontics 1223P0700X
License
DN014685 (GA)
Practice address
801 Florida Rd Unit 2
Durango, CO 81301-4775
Phone
(970) 259-0113
NPI assigned
Aug 24, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DEN-9527COMDProsthodontist
DN014685GAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Associates of the Southwest Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DEN-9527 CO
Prosthodontics 1223P0700X DN014685 GA Yes

Addresses

Primary practice location

801 Florida Rd Unit 2
Durango, CO 81301-4775

Mailing address

1545 Powers Ferry Rd SE Ste 220
Marietta, GA 30067-9401
Phone (770) 980-9404

Other providers in Durango, CO

All providers in Durango, CO · Prosthodontics in Colorado

Sources for this page

Verify at the official NPI Registry.