Provider Demographics
NPI:1790932879
Name:WROBEL, JAROSLAW ADAM (DDS)
Entity Type:Individual
Prefix:
First Name:JAROSLAW
Middle Name:ADAM
Last Name:WROBEL
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 1:2801 E 120TH AVE
Mailing Address - Street 2:#I 303
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-1499
Mailing Address - Country:US
Mailing Address - Phone:949-878-6661
Mailing Address - Fax:
Practice Address - Street 1:14422 ORCHARD PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80023-9273
Practice Address - Country:US
Practice Address - Phone:303-659-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10603122300000X
CA57599122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist