Provider Demographics
NPI:1124792395
Name:ALDWEESH, FAWAZ (DDS)
Entity type:Individual
Prefix:DR
First Name:FAWAZ
Middle Name:
Last Name:ALDWEESH
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 1:3445 N SALIDA ST STE 30
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-5000
Mailing Address - Country:US
Mailing Address - Phone:303-366-3383
Mailing Address - Fax:
Practice Address - Street 1:4930 S YOSEMITE ST STE D1B
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1382
Practice Address - Country:US
Practice Address - Phone:720-613-3081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002047801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice