Provider Demographics
NPI:1407032519
Name:DANIEL R. GEORGE
Entity Type:Organization
Organization Name:DANIEL R. GEORGE
Other - Org Name:ASPEN ORAL & MAXILLOFACIAL SURGERY
Other - Org Type:Other Name
Authorized Official - Title/Position:SURGEON/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:970-925-8210
Mailing Address - Street 1:630 E HYMAN AVE
Mailing Address - Street 2:SUITE 22
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1995
Mailing Address - Country:US
Mailing Address - Phone:970-925-8210
Mailing Address - Fax:970-925-1793
Practice Address - Street 1:630 E HYMAN AVE
Practice Address - Street 2:SUITE 22
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1995
Practice Address - Country:US
Practice Address - Phone:970-925-8210
Practice Address - Fax:970-925-1793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO198174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1174547517OtherNPI INDIVIDUAL
COC804828OtherMEDICARE GROUP
COC804829OtherMEDICARE INDIVIDUAL
COU55283OtherUPIN