Provider Demographics
NPI:1346564457
Name:MINER, NICHOLAS W (DMD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:W
Last Name:MINER
Suffix:
Gender:M
Credentials:DMD
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Other - Credentials:
Mailing Address - Street 1:10450 PARK MEADOWS DR.
Mailing Address - Street 2:SUITE #308
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124
Mailing Address - Country:US
Mailing Address - Phone:303-793-0899
Mailing Address - Fax:303-793-0895
Practice Address - Street 1:10450 PARK MEADOWS DR
Practice Address - Street 2:SUITE #308
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5529
Practice Address - Country:US
Practice Address - Phone:303-793-0899
Practice Address - Fax:303-793-0895
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO104311223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry