Provider Demographics
NPI:1720442148
Name:UPPAL, PRIYA (DDS)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:UPPAL
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 1:1310 ROSEWOOD AVE UNIT 5A
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1173
Mailing Address - Country:US
Mailing Address - Phone:612-532-0323
Mailing Address - Fax:
Practice Address - Street 1:10442 TOWN CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-6094
Practice Address - Country:US
Practice Address - Phone:303-410-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00203082122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist