Provider Demographics
NPI:1639247612
Name:MILUSHEV, METODI (DMD)
Entity type:Individual
Prefix:
First Name:METODI
Middle Name:
Last Name:MILUSHEV
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6874 S IVY WAY
Mailing Address - Street 2:APT. 304
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6232
Mailing Address - Country:US
Mailing Address - Phone:617-938-7652
Mailing Address - Fax:
Practice Address - Street 1:250 S SABLE BLVD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-1522
Practice Address - Country:US
Practice Address - Phone:303-360-0991
Practice Address - Fax:303-364-9522
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO92181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice