Provider Demographics
NPI:1003999244
Name:DRUCKMAN, ROGER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:
Last Name:DRUCKMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 S MONACO PKWY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2168
Mailing Address - Country:US
Mailing Address - Phone:303-692-8693
Mailing Address - Fax:303-691-2836
Practice Address - Street 1:90 MADISON ST
Practice Address - Street 2:506
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5418
Practice Address - Country:US
Practice Address - Phone:303-691-2860
Practice Address - Fax:303-691-2836
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1041301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice