Provider Demographics
NPI:1205346681
Name:WOYTEK, THERESA
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:WOYTEK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16105 WASHINGTON ST APT 6306
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9029
Mailing Address - Country:US
Mailing Address - Phone:928-486-4687
Mailing Address - Fax:
Practice Address - Street 1:13606 XAVIER LN STE F
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-3604
Practice Address - Country:US
Practice Address - Phone:303-465-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO906124124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty