Organization
BOULDER ORTHODONTICS
Active
Parent organization
BOULDER ORTHODONTICS
Other names
Firestone Orthodontics
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOULDER ORTHODONTICS
Authorized official
DR. JAMON VERL JENSEN (OWNER)
(303) 833-0310
Entity
Organization
Contact information
Practice address
704 1ST ST, FIRESTONE, CO 80520-5006
(303) 833-0310
Mailing address
2710 PEARL ST, BOULDER, CO 80302-3814
(303) 449-3250
(303) 449-1693
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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