Blue Mesa Dentistry at Southglenn

NPI #1881747319 in Centennial, Colorado

Provider Information

NPI Number: 1881747319
Entity Type: Organization
Organization Name: Blue Mesa Dentistry at Southglenn
Primary Specialty: Dentist
Enumeration Date: Jan 19, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 2001 E EASTER AVE
Address 2: #200
City: Centennial
State: Colorado
ZIP Code: 80122
Phone: (303) 703-4544

Authorized Official

Name: MARISSA ANNE NICHOLSON
Title: OFFICE MANAGER
Phone: (303) 703-4544

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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