# VIDA ORTHODONTICS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023615556
- **Authorized official:** DR. KRYSTAL HOVERSTEN DDS, MS (ORTHODONTIST)
- **Authorized official phone:** (701) 426-0938

## Contact information

- **Practice address:** 19551 HESS RD UNIT 110, PARKER, CO 80134-3446
- **Practice address phone:** (701) 426-0938
- **Mailing address:** 4519 W 37TH PL, DENVER, CO 80212-2395
- **Mailing address phone:** (701) 426-0938

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/07/2020
- **Last updated:** 10/07/2020