# BROOMFIELD PREMIER DENTISTRY, PC

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

## Provider details

- **NPI number:** 1316707359
- **Authorized official:** DR. DOMINIC S ITALIA DDS (PRESIDENT)
- **Authorized official phone:** (303) 460-9366

## Contact information

- **Practice address:** 899 HWY 287 STE 600, BROOMFIELD, CO 80020-7319
- **Practice address phone:** (303) 460-9366
- **Mailing address:** 899 HWY 287 STE 600, BROOMFIELD, CO 80020-7319
- **Mailing address phone:** (303) 460-9366

## Taxonomy

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

## Other

- **Enumeration date:** 03/19/2024
- **Last updated:** 03/19/2024