Provider Demographics
NPI:1568776268
Name:PAICE, JAROM THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAROM
Middle Name:THOMAS
Last Name:PAICE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 W SOUTH BOULDER RD
Mailing Address - Street 2:200
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2097
Mailing Address - Country:US
Mailing Address - Phone:303-604-2804
Mailing Address - Fax:303-604-0576
Practice Address - Street 1:535 W SOUTH BOULDER RD
Practice Address - Street 2:200
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2097
Practice Address - Country:US
Practice Address - Phone:303-604-2804
Practice Address - Fax:303-604-0576
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10236122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist