Organization
VIDA ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRYSTAL HOVERSTEN DDS, MS (ORTHODONTIST)
(701) 426-0938
Entity
Organization
Contact information
Practice address
19551 HESS RD UNIT 110, PARKER, CO 80134-3446
(701) 426-0938
Mailing address
4519 W 37TH PL, DENVER, CO 80212-2395
(701) 426-0938
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/07/2020
Last updated
10/07/2020
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