Mountain Dental PC

NPI #1922244193 in Broomfield, Colorado

Provider Information

NPI Number: 1922244193
Entity Type: Organization
Organization Name: Mountain Dental PC
Subpart: Yes (part of a larger organization)
Parent Organization: MOUNTAIN DENTAL INC
Primary Specialty: Dentist
Enumeration Date: Dec 18, 2008
Last Updated: Dec 18, 2008

Practice Location

Address: 300 NICKEL ST STE 11
City: Broomfield
State: Colorado
ZIP Code: 80020-2097
Phone: (303) 635-1816

Authorized Official

Name: LORI PELKE
Title: PROFESSIONAL SERVICES
Phone: (715) 926-5050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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