Provider Demographics
NPI:1205198983
Name:DHOON, TAHER (DMD)
Entity Type:Individual
Prefix:DR
First Name:TAHER
Middle Name:
Last Name:DHOON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 61ST AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-8059
Mailing Address - Country:US
Mailing Address - Phone:970-352-4242
Mailing Address - Fax:970-352-4246
Practice Address - Street 1:1813 61ST AVE STE 210
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634
Practice Address - Country:US
Practice Address - Phone:970-352-4242
Practice Address - Fax:970-352-4246
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6421122300000X
CO00202333122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist