Organization
COLORADO DENTAL SPECIALIST PRACTICE, LLC
Active
Parent organization
COLORADO DENTAL SPECIALIST PRACTICE, LLC
Other names
Colorado Endodontic Group, All Smiles Orthodontics, Colorado Dental Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLORADO DENTAL SPECIALIST PRACTICE, LLC
Authorized official
MICHELLE JOHNSON (CREDENTIALING SPECIALISTS)
(509) 315-8338
Entity
Organization
Contact information
Practice address
150 MORNING SUN DR STE 200W, WOODLAND PARK, CO 80863-9160
(719) 484-8490
Mailing address
150 MORNING SUN DR STE 200W, WOODLAND PARK, CO 80863-9160
(719) 484-8490
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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