Colorado Dental Specialist Practice, LLC
NPI #1124672753 in Superior, Colorado
Provider Information
- NPI Number
- 1124672753
- Entity Type
- Organization
- Organization Name
- Colorado Dental Specialist Practice, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- COLORADO DENTAL SPECIALIST PRACTICE, LLC
- Primary Specialty
- Dentist - Periodontics
- Enumeration Date
- Jul 31, 2019
- Last Updated
- Jul 31, 2019
Practice Location
Authorized Official
- Name
- MICHELLE JOHNSON
- Title
- CREDENTIALING SPECIALIST
- Phone
- (509) 315-8338
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Endodontics — Endodontics |
| Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics |
| Dentist - Periodontics — Periodontics |
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