Provider Demographics
NPI:1679099352
Name:GANDER, DEBRA LEE (DDDS, MS)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:LEE
Last Name:GANDER
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Gender:F
Credentials:DDDS, MS
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Mailing Address - Street 1:7447 E BERRY AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7447 E BERRY AVE STE 230
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2107
Practice Address - Country:US
Practice Address - Phone:303-741-3300
Practice Address - Fax:303-694-6270
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CODEN.000072541223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology