Organization
COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC
Active
Parent organization
COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC
Other names
Sage Orthodontics
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC
Authorized official
MICHELLE JOHNSON (CREDENTIALING SPECIALIST)
(509) 315-8338
Entity
Organization
Contact information
Practice address
1005 W 120TH AVE STE 800, WESTMINSTER, CO 80234-2747
(720) 263-5420
Mailing address
1005 W 120TH AVE STE 800, WESTMINSTER, CO 80234-2747
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
05/05/2021
Last updated
05/05/2021
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