Provider Demographics
NPI:1164519161
Name:SWANSON-CULBERTSON, PEGGY R (DDS)
Entity Type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:R
Last Name:SWANSON-CULBERTSON
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 1:162 ADAMS ST
Mailing Address - Street 2:SUITE #200-B
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5239
Mailing Address - Country:US
Mailing Address - Phone:303-292-3366
Mailing Address - Fax:303-292-3678
Practice Address - Street 1:1860 LARIMER ST
Practice Address - Street 2:STE #240
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1438
Practice Address - Country:US
Practice Address - Phone:303-292-3366
Practice Address - Fax:303-292-3678
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHD1047101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice