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Organization

ADVANCED FAMILY DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KIMBERLY A MCCLESKEY (PRACTICE ADMINISTRATOR)
(303) 985-8000
Entity
Organization

Contact information

Practice address
2598 S LEWIS WAY STE 3C, LAKEWOOD, CO 80227-2292
(303) 985-8000
(303) 985-8099
Mailing address
2598 S LEWIS WAY STE 3C, LAKEWOOD, CO 80227-2292
(303) 985-8000
(303) 985-8099

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1033366760
DENTAL
CO
01
1225325558
DENTAL
CO
Enumeration date
08/09/2012
Last updated
08/09/2012
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