Provider Demographics
NPI:1265685796
Name:KETURKA, KRISTINA ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:ELIZABETH
Last Name:KETURKA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:KETURKA
Other - Last Name:HARVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25521 E SMOKY HILL RD UNIT 140
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1346
Mailing Address - Country:US
Mailing Address - Phone:720-457-9300
Mailing Address - Fax:
Practice Address - Street 1:25521 E SMOKY HILL RD UNIT 140
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1346
Practice Address - Country:US
Practice Address - Phone:720-457-9300
Practice Address - Fax:720-457-9301
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9405122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist