Provider Demographics
NPI:1457529059
Name:MURZYN-DANTZER, LINDA (DMD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:MURZYN-DANTZER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13123 E 16TH AVE # B240
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7106
Mailing Address - Country:US
Mailing Address - Phone:720-777-6788
Mailing Address - Fax:720-777-7239
Practice Address - Street 1:13123 E 16TH AVE # B240
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-6788
Practice Address - Fax:720-777-7239
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO95561223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9556OtherLICENSE NUMBER
CO88770842Medicaid