Organization
MISSISSIPPI DENTAL GROUP P.C.
Active
Other names
Mississippi Dental Group P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE SUMMERS (CREDENTIALING)
(303) 285-6098
Entity
Organization
Contact information
Practice address
11175 E MISSISSIPPI AVE, SUITE 110, AURORA, CO 80012-3137
(303) 343-9313
(303) 343-9537
Mailing address
11175 E MISSISSIPPI AVE, SUITE 110, AURORA, CO 80012-3137
(303) 343-9313
(303) 343-9537
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6097
CO
Other
Enumeration date
04/03/2007
Last updated
08/22/2020
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