Provider Demographics
NPI:1255332516
Name:WITZEL, DAVID AREL (DDS MSD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:AREL
Last Name:WITZEL
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 S PEORIA ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3182
Mailing Address - Country:US
Mailing Address - Phone:303-696-6119
Mailing Address - Fax:303-750-1374
Practice Address - Street 1:2900 S PEORIA ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3182
Practice Address - Country:US
Practice Address - Phone:303-696-6119
Practice Address - Fax:303-750-1374
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO22854843Medicaid