Provider Demographics
NPI:1306074661
Name:DAMIAN, ANGELICA MARIA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANGELICA
Middle Name:MARIA
Last Name:DAMIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6169 S BALSAM WAY
Mailing Address - Street 2:STE 330
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-3064
Mailing Address - Country:US
Mailing Address - Phone:303-933-8230
Mailing Address - Fax:720-746-6342
Practice Address - Street 1:1200 S WADSWORTH BLVD
Practice Address - Street 2:#105
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-5473
Practice Address - Country:US
Practice Address - Phone:303-733-7533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO99491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice