Provider Demographics
NPI:1164473625
Name:STRANGE, DAVID MALCOLM (DDS,MSD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MALCOLM
Last Name:STRANGE
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 W 38TH AVE
Mailing Address - Street 2:#306
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4300
Mailing Address - Country:US
Mailing Address - Phone:303-467-8888
Mailing Address - Fax:303-467-8801
Practice Address - Street 1:8550 W 38TH AVE
Practice Address - Street 2:#306
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4300
Practice Address - Country:US
Practice Address - Phone:303-467-8888
Practice Address - Fax:303-467-8801
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO06511223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04023644Medicaid
CO04011771Medicaid
CO04011383Medicaid
CO04021770Medicare ID - Type UnspecifiedVAIL VALLEY