Provider Demographics
NPI:1891755013
Name:EGERT, TERRY (DDS)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:EGERT
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 1:3955 E EXPOSITION AVE
Mailing Address - Street 2:#312
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-5000
Mailing Address - Country:US
Mailing Address - Phone:303-744-3636
Mailing Address - Fax:303-744-3724
Practice Address - Street 1:3955 E EXPOSITION AVE
Practice Address - Street 2:#312
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-5000
Practice Address - Country:US
Practice Address - Phone:303-744-3636
Practice Address - Fax:303-744-3724
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1044161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice