Provider Demographics
NPI:1417299132
Name:BASILE, LAUREN ELIZABETH (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:BASILE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3701 S CLARKSON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3960
Mailing Address - Country:US
Mailing Address - Phone:303-806-8600
Mailing Address - Fax:303-806-8629
Practice Address - Street 1:3701 S CLARKSON ST STE 300
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3960
Practice Address - Country:US
Practice Address - Phone:303-806-8600
Practice Address - Fax:303-806-8629
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADR60360447204E00000X
CO2031471223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery