Provider Demographics
NPI:1700104494
Name:CIRAC, CODY EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:EUGENE
Last Name:CIRAC
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22499 E MOSEY CIR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-6315
Mailing Address - Country:US
Mailing Address - Phone:714-916-4765
Mailing Address - Fax:
Practice Address - Street 1:18680 E ILIFF AVE STE A&B
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-6540
Practice Address - Country:US
Practice Address - Phone:303-751-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002041271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice