My Local Colorado Dental Practice, LLC

NPI #1245870336 in Lakewood, Colorado

Provider Information

NPI Number
1245870336
Entity Type
Organization
Organization Name
My Local Colorado Dental Practice, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
MY LOCAL COLORADO DENTAL PRACTICE, LLC
Primary Specialty
Dentist - General Practice
Enumeration Date
Jan 7, 2020
Last Updated
Jan 7, 2020

Practice Location

Address
264 UNION BLVD STE 200
ZIP Code
80228-1970
Phone
(303) 477-7700

Authorized Official

Name
MICHELLE JOHNSON
Title
CREDENTIALING SPECIALIST
Phone
(509) 315-8338

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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