My Local Colorado Dental Practice, LLC

NPI #1366096893 in Windsor, Colorado

Provider Information

NPI Number
1366096893
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
Aug 1, 2019
Last Updated
Aug 1, 2019

Practice Location

Address
1160 W ASH ST
ZIP Code
80550-4666
Phone
(970) 686-1186

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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