Provider Demographics
NPI:1003297029
Name:CLAIRE-MARIE FICSOR DMD PLLC
Entity Type:Organization
Organization Name:CLAIRE-MARIE FICSOR DMD PLLC
Other - Org Name:WINDERMERE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEP
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAIRE-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FICSOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-798-4571
Mailing Address - Street 1:5590 S WINDERMERE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-1245
Mailing Address - Country:US
Mailing Address - Phone:303-798-4571
Mailing Address - Fax:
Practice Address - Street 1:5590 S WINDERMERE ST
Practice Address - Street 2:SUITE A
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-1245
Practice Address - Country:US
Practice Address - Phone:303-798-4571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN00201899122300000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty