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NPI 1124331004

IndividualActive

Marisa Patt, DMD

NPI 1124331004 · Prosthodontics · Boulder, CO

Provider details

NPI number: 1124331004
Entity type: Individual
Primary specialty: ProsthodonticsDental Providers
Credential: DMD
Sex: Female
Sole proprietor: Yes
License: 00203089 (CO)

Practice location

7490 Clubhouse Rd Ste 101

Boulder, CO 80301-3720

Phone: (303) 530-1212

More CO providers

Mailing address

595 Madison Ave

New York, NY 10022-1907

Registry dates

Enumerated: 2010-07-20
Last updated: 2023-07-06

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Marisa Patt, DMD — NPI 1124331004, Boulder, CO | NPI Central