Provider Demographics
NPI:1659312767
Name:LATTA, JAMES E (DDS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:LATTA
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:200 W COUNTY LINE RD
Mailing Address - Street 2:#230
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2360
Mailing Address - Country:US
Mailing Address - Phone:303-791-0422
Mailing Address - Fax:303-791-0564
Practice Address - Street 1:200 W COUNTY LINE RD
Practice Address - Street 2:#230
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2360
Practice Address - Country:US
Practice Address - Phone:303-791-0422
Practice Address - Fax:303-791-0564
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO008401223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO698152OtherUNITED CONCORDIA
COU29525Medicare UPIN
CO86975Medicare ID - Type Unspecified