Provider Demographics
NPI:1699803189
Name:DERLOSHON, TOBIAS M (DDS)
Entity type:Individual
Prefix:DR
First Name:TOBIAS
Middle Name:M
Last Name:DERLOSHON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 WARD RD STE 202
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1300
Mailing Address - Country:US
Mailing Address - Phone:303-423-5437
Mailing Address - Fax:303-423-1121
Practice Address - Street 1:5730 WARD RD STE 202
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002
Practice Address - Country:US
Practice Address - Phone:303-423-5437
Practice Address - Fax:303-423-1121
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO061771223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry