Organization
KIDS TOOTH DOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN FOX (MANAGER)
(303) 974-5868
Entity
Organization
Contact information
Practice address
9358 DORCHESTER ST, SUITE 106, HIGHLANDS RANCH, CO 80129-2511
(303) 974-5868
Mailing address
5168 S BROADWAY, ENGLEWOOD, CO 80113-6706
(303) 974-5868
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/15/2016
Last updated
11/15/2016
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