Organization
LONE TREE MODERN DENTAL, PROFESSIONAL
Active
Other names
Lone Tree Modern Dental and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA HALLINAN DMD (ASSOCIATE)
(720) 943-2153
Entity
Organization
Contact information
Practice address
9227 E LINCOLN AVE, SUITE #800, LONE TREE, CO 80124-5506
(720) 943-2153
Mailing address
9227 E LINCOLN AVE, SUITE #800, LONE TREE, CO 80124-5506
(720) 943-2153
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
201999
CO
1223G0001X
General Practice Dentistry
Primary
201999
CO
1223P0300X
Periodontics
201999
CO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
201999
CO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
201999
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201999
STATE OF COLORADO
CO
Enumeration date
09/19/2014
Last updated
09/19/2014
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