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Organization

CO SPECIALTY DENTAL SERVICES, PLLC

Active
Parent organization
CO SPECIALTY DENTAL SERVICES, PLLC
Other names
Foothills Pediatric Dentistry
Organization subpart
Yes

Provider details

NPI number
Legal business name
CO SPECIALTY DENTAL SERVICES, PLLC
Authorized official
CHARLOTTE DASCH (DIRECTOR OF CRED AND PROVR REL)
(504) 638-0303
Entity
Organization

Contact information

Practice address
916 S MAIN ST UNIT 302, LONGMONT, CO 80501-6672
(303) 702-9501
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
05/29/2024
Last updated
03/26/2025
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