Provider Demographics
NPI:1033481056
Name:DOFEK, BRETISLAV JOSEF
Entity Type:Individual
Prefix:
First Name:BRETISLAV
Middle Name:JOSEF
Last Name:DOFEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 S PARFET CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80232-6130
Mailing Address - Country:US
Mailing Address - Phone:303-525-8990
Mailing Address - Fax:
Practice Address - Street 1:4500 CHERRY CREEK DR. SOUTH
Practice Address - Street 2:SUITE 940
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246
Practice Address - Country:US
Practice Address - Phone:303-322-7108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO296OtherMAXIM