Organization
PROFESSIONAL DENTAL CARE OF SOUTHERN COLORADO I PLLC
Active
Parent organization
SSUN HEALTH, LLC
Other names
Thompson Smiles
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSUN HEALTH, LLC
Authorized official
CARY LACOUTURE DDS (CLINICAL DIRECTOR)
(303) 521-5701
Entity
Organization
Contact information
Practice address
123 W 2ND ST, PORTALES, NM 88130-6201
(575) 268-0007
Mailing address
10233 S PARKER RD STE 107, PARKER, CO 80134-9314
(303) 521-5701
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/08/2021
Last updated
02/08/2021
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