Provider Demographics
NPI:1225541972
Name:THOMAS K. CHUBB, DDS, PC
Entity Type:Organization
Organization Name:THOMAS K. CHUBB, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:CHUBB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-428-3613
Mailing Address - Street 1:5150 W 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80030-4449
Mailing Address - Country:US
Mailing Address - Phone:303-428-3613
Mailing Address - Fax:303-427-4631
Practice Address - Street 1:5150 W 80TH AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80030-4449
Practice Address - Country:US
Practice Address - Phone:303-428-3613
Practice Address - Fax:303-427-4631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO68481223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty