Organization
SOUTHPARK ORTHODONTICS
Active
Organization
SOUTHPARK ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KO (OFFICE MANAGER)
(303) 738-8828
Entity
Organization
Contact information
Practice address
8199 SOUTHPARK LN, SUITE 150, LITTLETON, CO 80120-5667
(303) 738-8828
(303) 738-8823
Mailing address
8199 SOUTHPARK LN, SUITE 150, LITTLETON, CO 80120-5667
(303) 738-8828
(303) 738-8823
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7924
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60387831
—
CO
Enumeration date
01/05/2007
Last updated
08/22/2020
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