# JOSEPH J. WIDDISON, DMD, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LakeView Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154657294
- **Authorized official:** DIANE LEA SMITH (REGIONAL DIRECTOR)
- **Authorized official phone:** (720) 371-2309

## Contact information

- **Practice address:** 2502 ABARR DR, LOVELAND, CO 80538-3156
- **Practice address phone:** (970) 669-1444
- **Mailing address:** 2502 ABARR DR, LOVELAND, CO 80538-3156
- **Mailing address phone:** (970) 669-1444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 9379 | CO | Yes |

## Other

- **Enumeration date:** 10/24/2009
- **Last updated:** 10/24/2009