Organization
DENTISTRY360
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEMI CONDOIANIS DDS (OWNER)
(214) 693-4022
Entity
Organization
Contact information
Practice address
5140 W DARTMOUTH AVE, DENVER, CO 80236-2007
(720) 596-4760
(720) 596-4943
Mailing address
5140 W DARTMOUTH AVE, DENVER, CO 80236-2007
(720) 596-4760
(720) 596-4943
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
10276
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58206051
—
CO
Enumeration date
05/24/2012
Last updated
05/24/2012
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