Organization
GREEN VALLEY RANCH COSMETIC & FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON N WHITING DMD (OWNER)
(303) 501-0763
Entity
Organization
Contact information
Practice address
4809 ARGONNE ST, DENVER, CO 80249-6834
(303) 501-0763
(303) 317-8191
Mailing address
4809 ARGONNE ST, DENVER, CO 80249-6834
(303) 501-0763
(303) 317-8191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10061
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265421077
INDIVIDUAL NPI
WY
Enumeration date
12/20/2009
Last updated
12/20/2009
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