Provider Demographics
NPI:1326143272
Name:POCZATEK, SHARON BONNIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:BONNIE
Last Name:POCZATEK
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 1:2800 VALMONT RD
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1310
Mailing Address - Country:US
Mailing Address - Phone:303-444-3232
Mailing Address - Fax:303-444-3242
Practice Address - Street 1:2800 VALMONT RD
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1310
Practice Address - Country:US
Practice Address - Phone:303-444-3232
Practice Address - Fax:303-444-3242
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO1051931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice