Provider Demographics
NPI:1124232558
Name:COFFEE, PAULA K (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:K
Last Name:COFFEE
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 1:9553 E CHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1325
Mailing Address - Country:US
Mailing Address - Phone:303-721-4580
Mailing Address - Fax:
Practice Address - Street 1:11031 S PIKES PEAK DR
Practice Address - Street 2:STE. 103
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7389
Practice Address - Country:US
Practice Address - Phone:393-841-4580
Practice Address - Fax:303-841-7765
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO105608122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist