Organization
OPEN AND AFFORDABLE DENTAL PARKER WEST PLLC
Active
Other names
Open and Affordable Dental Parker West
Organization subpart
No
Provider details
NPI number
Authorized official
IGOR TRAKTINSKIY (OWNER)
(303) 768-8137
Entity
Organization
Contact information
Practice address
12501 E LINCOLN AVE UNIT 102, ENGLEWOOD, CO 80112-4753
(303) 768-8137
Mailing address
12501 E LINCOLN AVE UNIT 102, ENGLEWOOD, CO 80112-4753
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000161964
—
CO
Enumeration date
06/03/2020
Last updated
06/09/2020
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