Organization
KIDS & FAMILY DENTISTRY & ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER H KO (OPERATING MANAGER)
(303) 254-8828
Entity
Organization
Contact information
Practice address
2300 E 120TH AVE, SUITE #104, THORNTON, CO 80233-2484
(303) 254-8828
(303) 254-8827
Mailing address
2300 E 120TH AVE, SUITE #104, THORNTON, CO 80233-2484
(303) 254-8828
(303) 254-8827
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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