Provider Demographics
NPI:1336230408
Name:DECINO, DONALD ALFRED (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ALFRED
Last Name:DECINO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3405 S YARROW ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-4965
Mailing Address - Country:US
Mailing Address - Phone:303-996-8500
Mailing Address - Fax:303-996-8501
Practice Address - Street 1:3405 S YARROW ST
Practice Address - Street 2:SUITE A
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-4965
Practice Address - Country:US
Practice Address - Phone:303-996-8500
Practice Address - Fax:303-996-8501
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO59261223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery