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Organization

RIVERWALK DENTAL ARTS, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KATHERINE T JOHNSON DDS (MEMBER)
(303) 829-0591
Entity
Organization

Contact information

Practice address
115 WILCOX ST STE 123, CASTLE ROCK, CO 80104-1992
(303) 829-0591
Mailing address
15585 W HARVARD AVE, LAKEWOOD, CO 80228-5546
(303) 829-0591

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9903
COLORAD STATE DENTAL LICENSE
CO
Enumeration date
09/24/2019
Last updated
09/24/2019
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