Organization
COLORADO KIDS PEDIATRIC DENTISTRY
Active
Parent organization
COLORADO KIDS PEDIATRIC DENTISTRY
Other names
Drs. Fox, Waguespack & Norwood
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLORADO KIDS PEDIATRIC DENTISTRY
Authorized official
DR. LISA MEHELICH FOX DDS (OWNER/OPERATOR)
(303) 791-4400
Entity
Organization
Contact information
Practice address
9227 E LINCOLN AVE STE 100, LONE TREE, CO 80124-5504
(303) 225-4715
(303) 688-6012
Mailing address
9227 E LINCOLN AVE STE 100, LONE TREE, CO 80124-5504
(303) 225-4715
(303) 688-6012
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
00201980
CO
1223P0221X
Pediatric Dentistry
674
CO
1223P0221X
Pediatric Dentistry
Primary
8330
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215048806
KATHLEEN E. WAGUESPACK, DMD NPI
CO
01
—
1427078435
LISA MEHELICH FOX, DDS NPI
CO
Enumeration date
01/25/2007
Last updated
06/23/2020
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