# FAMILY DENTISTRY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1104186501
- **Authorized official:** DR. COLLIS JOHNSON JR. DDS (OWNER/DENTIST)
- **Authorized official phone:** (303) 322-1177

## Contact information

- **Practice address:** 1756 VINE ST, DENVER, CO 80206-1120
- **Practice address phone:** (303) 322-1177
- **Practice address fax:** (303) 322-1199
- **Mailing address:** 1756 VINE ST, DENVER, CO 80206-1120
- **Mailing address phone:** (303) 322-1177
- **Mailing address fax:** (303) 322-1199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | 104176 | CO | Yes |

## Other

- **Enumeration date:** 05/21/2012
- **Last updated:** 05/21/2012