Organization
ICON DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAZELI TARJAN (DENTIST/OWNER)
(641) 821-0256
Entity
Organization
Contact information
Practice address
1425 MARKET ST STE 100, DENVER, CO 80202-1708
(641) 821-0256
Mailing address
1425 MARKET ST STE 100, DENVER, CO 80202-1708
(641) 821-0256
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9970
CO
Other
Enumeration date
05/19/2014
Last updated
05/19/2014
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