My Local Colorado Dental Practice, LLC

NPI #1528612298 in Falcon, Colorado

Provider Information

NPI Number
1528612298
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
Jul 30, 2019
Last Updated
Jul 30, 2019

Practice Location

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

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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