Provider Demographics
NPI:1841404993
Name:AVERBACH, ROBERT E (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:AVERBACH
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 1:155 COOK ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5325
Mailing Address - Country:US
Mailing Address - Phone:303-321-7930
Mailing Address - Fax:303-321-5113
Practice Address - Street 1:155 COOK ST
Practice Address - Street 2:SUITE 301
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5325
Practice Address - Country:US
Practice Address - Phone:303-321-7930
Practice Address - Fax:303-321-5113
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1541223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics