Organization
COLORADO DENTAL PROFESSIONALS, LLC
Active
Parent organization
COLORADO DENTAL PROFESSIONALS, LLC
Other names
Coal Creek Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLORADO DENTAL PROFESSIONALS, LLC
Authorized official
JESSICA BRITT (CREDENTIALING COORDINATOR)
(217) 540-8426
Entity
Organization
Contact information
Practice address
440 ERIE PKWY, ERIE, CO 80516
(217) 540-5100
Mailing address
440 ERIE PKWY, ERIE, CO 80516
(217) 540-5100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/03/2017
Last updated
11/03/2017
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