Provider Demographics
NPI:1487742656
Name:REDFORD, DAVID Y II (DMD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:Y
Last Name:REDFORD
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 16TH ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-2943
Mailing Address - Country:US
Mailing Address - Phone:303-534-7797
Mailing Address - Fax:303-446-8645
Practice Address - Street 1:910 16TH ST
Practice Address - Street 2:SUITE 700
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-2943
Practice Address - Country:US
Practice Address - Phone:303-534-7797
Practice Address - Fax:303-446-8645
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO84101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice