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Organization
FAMILY DENTISTRY
Active
Organization
FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLLIS JOHNSON JR. DDS (OWNER/DENTIST)
(303) 322-1177
Entity
Organization
Contact information
Practice address
1756 VINE ST, DENVER, CO 80206-1120
(303) 322-1177
(303) 322-1199
Mailing address
1756 VINE ST, DENVER, CO 80206-1120
(303) 322-1177
(303) 322-1199
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
104176
CO
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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