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Organization

COLORADO DHCA, BOULDER, PLLC

Active
Other names
Dental Health of Boulder, PLLC
Organization subpart
No

Provider details

NPI number
Authorized official
ANDE WITTENBERG (MANAGER)
(303) 443-0070
Entity
Organization

Contact information

Practice address
2525 28TH ST UNIT 140, BOULDER, CO 80301-1255
(303) 443-0070
(303) 443-0073
Mailing address
2525 28TH ST UNIT 140, BOULDER, CO 80301-1255
(303) 443-0070
(303) 443-0073

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
579
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
841525799
SPECIALTY
CO
Enumeration date
02/21/2007
Last updated
07/09/2008
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