Organization
MILOT PEDIATRIC DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER MILOT DDS (OWNER/DENTIST)
(503) 719-3700
Entity
Organization
Contact information
Practice address
2055 KEN PRATT BLVD, UNIT B, LONGMONT, CO 80501-6554
(503) 719-3700
Mailing address
2851 SHADOW LAKE RD, LAFAYETTE, CO 80026-8970
(503) 719-3700
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9409
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53451767
—
CO
Enumeration date
05/18/2016
Last updated
11/08/2016
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