# JUAN MATERON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tu Sonrisa Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093303117
- **Authorized official:** MS. MARY LOU A POSADA (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (720) 276-3046

## Contact information

- **Practice address:** 11275 E MISSISSIPPI AVE STE 1E3, AURORA, CO 80012-2818
- **Practice address phone:** (720) 440-2233
- **Practice address fax:** (303) 557-6102
- **Mailing address:** 11275 E MISSISSIPPI AVE STE 1E3, AURORA, CO 80012-2818
- **Mailing address phone:** (720) 440-2233
- **Mailing address fax:** (303) 557-6102

## Taxonomy

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

## Other

- **Enumeration date:** 01/05/2021
- **Last updated:** 01/05/2021