Organization
PEDO THREE, PROF. LLC
Active
Other names
GRiN Pediatric Dentistry & Orthodontics of Centennial, Comfort Dental Kids Centennial
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLTON FLAKE DDS (PRESIDENT)
(720) 277-5930
Entity
Organization
Contact information
Practice address
6870 S UNIVERSITY BLVD, CENTENNIAL, CO 80122-1515
(720) 277-5930
(720) 241-7811
Mailing address
6870 S UNIVERSITY BLVD STE O, CENTENNIAL, CO 80122-1515
(720) 277-5930
(720) 241-7811
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10630
CO
1223P0221X
Pediatric Dentistry
10630
CO
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44075871
—
CO
Enumeration date
02/18/2009
Last updated
09/12/2023
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