Provider Demographics
NPI:1013561414
Name:SERRANO, GISELLE (DDS)
Entity Type:Individual
Prefix:
First Name:GISELLE
Middle Name:
Last Name:SERRANO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9102 GALE BLVD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-4976
Mailing Address - Country:US
Mailing Address - Phone:305-213-8806
Mailing Address - Fax:
Practice Address - Street 1:1927 COLORADO STATE HWY 7 STE 101
Practice Address - Street 2:STE 101
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516
Practice Address - Country:US
Practice Address - Phone:720-548-4240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204051122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist