Provider Demographics
NPI:1558679175
Name:GRITZMACHER, CHELSIE (DMD)
Entity Type:Individual
Prefix:
First Name:CHELSIE
Middle Name:
Last Name:GRITZMACHER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 E MINERAL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2611
Mailing Address - Country:US
Mailing Address - Phone:303-798-4400
Mailing Address - Fax:
Practice Address - Street 1:404 E MINERAL AVE STE A
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2611
Practice Address - Country:US
Practice Address - Phone:303-798-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 60169108122300000X
CODEN002041771223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist