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Organization

EXPERIENCE DENTAL PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEREMY RICHARD ALTDORFER DDS (CEO)
(740) 706-0765
Entity
Organization

Contact information

Practice address
1933 28TH ST STE 204, BOULDER, CO 80301-1100
(740) 706-0765
Mailing address
1933 28TH ST STE 204, BOULDER, CO 80301-1100
(740) 706-0765

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
09/23/2019
Last updated
01/07/2021
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