Provider Demographics
NPI:1093026031
Name:TROGDON, GAVIN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:GAVIN
Middle Name:A
Last Name:TROGDON
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 1:700 E SPEER BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-4256
Mailing Address - Country:US
Mailing Address - Phone:303-733-1010
Mailing Address - Fax:
Practice Address - Street 1:700 E SPEER BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-4256
Practice Address - Country:US
Practice Address - Phone:303-733-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6904122300000X
CO10672122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist