Provider Demographics
NPI:1114025160
Name:NEUGEBOREN, NEIL (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:NEUGEBOREN
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 1:3690S YOSEMITE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1808
Mailing Address - Country:US
Mailing Address - Phone:303-695-0990
Mailing Address - Fax:303-695-6915
Practice Address - Street 1:10200 E GIRARD AVE
Practice Address - Street 2:SUITE A- 209
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5500
Practice Address - Country:US
Practice Address - Phone:303-695-0990
Practice Address - Fax:303-695-6915
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO82311223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics