Provider Demographics
NPI:1710109087
Name:APGAR, GEORGANN LOUISE (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGANN
Middle Name:LOUISE
Last Name:APGAR
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 1:31891 BLACK WIDOW DR
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-9622
Mailing Address - Country:US
Mailing Address - Phone:301-641-7665
Mailing Address - Fax:
Practice Address - Street 1:951 E. 120TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233
Practice Address - Country:US
Practice Address - Phone:303-305-4466
Practice Address - Fax:301-657-3400
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.000095951223P0300X
CO95951223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics