Organization
COLORADO DENTAL PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN EVERETT BALLARD (CIO)
(972) 755-0800
Entity
Organization
Contact information
Practice address
8170 S UNIVERSITY BLVD, SUITE 240, CENTENNIAL, CO 80122-3196
(303) 770-1106
Mailing address
4100 MCEWEN RD, SUITE 110, DALLAS, TX 75244-5113
(972) 755-0800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8054
CO
Other
Enumeration date
10/27/2006
Last updated
08/22/2020
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