Provider Demographics
NPI:1093156077
Name:WAGUESPACK, DENNIS ERIC (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:ERIC
Last Name:WAGUESPACK
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8751 E HAMPDEN AVE
Mailing Address - Street 2:SUITE C-6
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4952
Mailing Address - Country:US
Mailing Address - Phone:303-755-4003
Mailing Address - Fax:303-743-9638
Practice Address - Street 1:8751 E HAMPDEN AVE
Practice Address - Street 2:SUITE C-6
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4952
Practice Address - Country:US
Practice Address - Phone:303-755-4003
Practice Address - Fax:303-743-9638
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002019761223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics