Provider Demographics
NPI:1013308659
Name:HANI MICHAEL MAROGIL DMD PC
Entity Type:Organization
Organization Name:HANI MICHAEL MAROGIL DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANI
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MAROGIL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-466-4646
Mailing Address - Street 1:340 E 1ST AVE
Mailing Address - Street 2:202
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2401
Mailing Address - Country:US
Mailing Address - Phone:303-466-4646
Mailing Address - Fax:303-404-8804
Practice Address - Street 1:340 E 1ST AVE
Practice Address - Street 2:202
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2401
Practice Address - Country:US
Practice Address - Phone:303-466-4646
Practice Address - Fax:303-404-8804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7330122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty