Colorado Dental Orthodontist Practice, Pllc

NPI #1902489123 in Fountain, Colorado

Provider Information

NPI Number
1902489123
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
8085 FOUNTAIN MESA RD
ZIP Code
80817-1591
Phone
(719) 382-5500

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Dentist - Orthodontics and Dentofacial OrthopedicsOrthodontics and Dentofacial Orthopedics

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