Organization
NEW IMAGE DENTAL IMPLANT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYNN MILLER (OFFICE ADMINISTRATOR)
(303) 321-8400
Entity
Organization
Contact information
Practice address
3737 E 1ST AVE, DENVER, CO 80206-7510
(303) 321-8400
Mailing address
3737 E 1ST AVE, DENVER, CO 80206-7510
(303) 321-8400
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
CO-104214
CO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
CO-7149
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO-104214
STARE LICENSE DR.DOBRO
CO
01
—
CO-7149
STATE LICENSE DR. STEIN
CO
Enumeration date
07/23/2010
Last updated
07/23/2010
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