Provider Demographics
NPI:1811593254
Name:UNGAR, DALE AUDREY
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:AUDREY
Last Name:UNGAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 BLAKE ST APT 1H
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1356
Mailing Address - Country:US
Mailing Address - Phone:954-668-7061
Mailing Address - Fax:954-389-8168
Practice Address - Street 1:1499 BLAKE ST APT 1H
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1356
Practice Address - Country:US
Practice Address - Phone:303-728-9746
Practice Address - Fax:954-389-8168
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist