Organization
MY LOCAL COLORADO DENTAL PRACTICE, LLC
Active
Parent organization
MY LOCAL COLORADO DENTAL PRACTICE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MY LOCAL COLORADO DENTAL PRACTICE, LLC
Authorized official
MICHELLE JOHNSON (CREDENTIALING SPECIALIST)
(509) 315-8338
Entity
Organization
Contact information
Practice address
990 S ABILENE ST, AURORA, CO 80012-3686
(720) 687-3983
Mailing address
6110 BARNES RD, COLORADO SPRINGS, CO 80922-2600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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