Organization
STAPLETON CHILDREN'S DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFAIYAZ IBRAHIM D.D.S. (OWNER)
(303) 399-5437
Entity
Organization
Contact information
Practice address
2373 CENTRAL PARK BLVD, SUITE 305, DENVER, CO 80238-2300
(303) 399-5437
(303) 399-5445
Mailing address
2373 CENTRAL PARK BLVD, SUITE 305, DENVER, CO 80238-2300
(303) 399-5437
(303) 399-5445
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9407
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265630784
INDIVIDUAL NPI
CO
Enumeration date
05/14/2009
Last updated
05/14/2009
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