Provider Demographics
NPI:1396830428
Name:LACOUTURE, CARY FRANCIS
Entity Type:Individual
Prefix:
First Name:CARY
Middle Name:FRANCIS
Last Name:LACOUTURE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 861
Mailing Address - Street 2:
Mailing Address - City:FRANKTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80116-0861
Mailing Address - Country:US
Mailing Address - Phone:303-688-2515
Mailing Address - Fax:303-688-2589
Practice Address - Street 1:7601 BURNING TREE DR
Practice Address - Street 2:
Practice Address - City:FRANKTOWN
Practice Address - State:CO
Practice Address - Zip Code:80116-9540
Practice Address - Country:US
Practice Address - Phone:303-688-2515
Practice Address - Fax:303-688-2589
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO59141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice