Provider Demographics
NPI:1063078996
Name:CHERTOK, NATHANIEL (DDS)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:
Last Name:CHERTOK
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 1:8181 ARISTA PL UNIT 140
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-7918
Mailing Address - Country:US
Mailing Address - Phone:303-427-4120
Mailing Address - Fax:
Practice Address - Street 1:8181 ARISTA PL UNIT 140
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-7918
Practice Address - Country:US
Practice Address - Phone:303-427-4120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN002050161223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics