Provider Demographics
NPI:1760550180
Name:DAY, BRIAN E (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:E
Last Name:DAY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 36 1/10 RD
Mailing Address - Street 2:
Mailing Address - City:PALISADE
Mailing Address - State:CO
Mailing Address - Zip Code:81526-9744
Mailing Address - Country:US
Mailing Address - Phone:970-464-4738
Mailing Address - Fax:
Practice Address - Street 1:125 WEST 3RD ST
Practice Address - Street 2:
Practice Address - City:PALISADE
Practice Address - State:CO
Practice Address - Zip Code:81526
Practice Address - Country:US
Practice Address - Phone:970-464-5123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO71801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7180OtherCOLORADO DENTAL LISC.#