Colorado Dental Orthodontist Practice, Pllc

NPI #1275116485 in Falcon, Colorado

Provider Information

NPI Number: 1275116485
Entity Type: Organization
Organization Name: Colorado Dental Orthodontist Practice, Pllc
Subpart: Yes (part of a larger organization)
Parent Organization: COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: May 5, 2021
Last Updated: May 5, 2021

Practice Location

Address: 7685 MCLAUGHLIN RD STE 100
City: Falcon
State: Colorado
ZIP Code: 80831-4751
Phone: (719) 694-1929

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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