Provider Demographics
NPI:1992129456
Name:GASCA, DARYL JORGE (DDS)
Entity type:Individual
Prefix:DR
First Name:DARYL
Middle Name:JORGE
Last Name:GASCA
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 1:1044 HIDDEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-8548
Mailing Address - Country:US
Mailing Address - Phone:720-648-7020
Mailing Address - Fax:
Practice Address - Street 1:1044 HIDDEN VALLEY DR
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-8548
Practice Address - Country:US
Practice Address - Phone:720-648-7020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-04
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002021451223P0300X
NMDD54901223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty