Provider Demographics
NPI:1952367096
Name:VETTER, JAMES DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:VETTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13065 E. 17TH AVE., ROOM 104N
Mailing Address - Street 2:MAIL STOP F851
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045
Mailing Address - Country:US
Mailing Address - Phone:303-724-8167
Mailing Address - Fax:719-592-9682
Practice Address - Street 1:13065 E 17TH AVE RM 104N
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2532
Practice Address - Country:US
Practice Address - Phone:303-724-8167
Practice Address - Fax:719-592-9682
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.000067091223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery