Provider Demographics
NPI:1104944552
Name:JARVIS, BYFORD THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:BYFORD
Middle Name:THOMAS
Last Name:JARVIS
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 1:6363 W 120TH AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020
Mailing Address - Country:US
Mailing Address - Phone:303-466-4660
Mailing Address - Fax:
Practice Address - Street 1:6363 W 120TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020
Practice Address - Country:US
Practice Address - Phone:303-466-4660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6136122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist