Organization
MY LOCAL COLORADO DENTAL PRACTICE, LLC
Active
Other names
Metropolitan Dental, Apple Tree Dental, Lowry Main Street Dental, Discovery Kids, East Harmony Dental, Greeley Dental Health, Lone Tree Modern Dental, Stapleton Modern Dental, GVR Dental and Orthodontics, Highlands Ranch Dental Group, Flatirons Family Dental and Orthodontics, Advantage Dental Group, Fountain Dental Center, College Ave Modern Dental, 38th Modern Dental, Hampden Dental Group, South Springs Dental Group, Mountain Shadows Dental, Sage Dental Care, Woodmen Dental Group, KIP Dental and Orthodontics, Woodland Park Dental Group, Colorado Dental Group, Windsor Family Dentistry, All Smiles Dental Group, Stetson Hills Dental, Panorama Dental, Castle Pines Dental Group, My Dentist
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE JOHNSON (CREDENTIALING SPECIALIST)
(509) 315-8338
Entity
Organization
Contact information
Practice address
3715 BLOOMINGTON ST UNIT 160, COLORADO SPRINGS, CO 80922-3207
(719) 599-0665
Mailing address
6110 BARNES RD, COLORADO SPRINGS, CO 80922-2600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/18/2018
Last updated
05/29/2019
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