Colorado Dental Specialist Practice, LLC

NPI #1407400039 in Thornton, Colorado

Provider Information

NPI Number: 1407400039
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

Address: 2800 E 136TH AVE
City: Thornton
State: Colorado
ZIP Code: 80241-3417
Phone: (720) 872-2892

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Endodontics — Endodontics	1223E0200X
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X
Dentist - Periodontics — Periodontics	1223P0300X	Primary

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DR. Georgann Louise Apgar, DMD	Dentist - Periodontics	Thornton	AI Deep Dive
DR. Craig J Hovick, DDS	Dentist - Periodontics	Longmont	AI Deep Dive
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Organizations

Provider Name	Specialty	City
Colorado Dental Specialist Practice, LLC Part of Colorado Dental Specialist Practice, LLC	Dentist - Periodontics	Thornton	AI Deep Dive

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