Provider Demographics
NPI:1457455644
Name:KILLINGSWORTH, YVETTE L (DDS)
Entity Type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:L
Last Name:KILLINGSWORTH
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 1:19700 E PARKER SQ DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7300
Mailing Address - Country:US
Mailing Address - Phone:303-841-2070
Mailing Address - Fax:303-841-1948
Practice Address - Street 1:19700 E PARKER SQ DR
Practice Address - Street 2:SUITE 1
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7300
Practice Address - Country:US
Practice Address - Phone:303-841-2070
Practice Address - Fax:303-841-1948
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO80261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice