Organization
NORTHGLENN DENTISTRY AND ORTHODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
421 W 104TH AVE STE 201, NORTHGLENN, CO 80234-4138
(303) 427-6462
Mailing address
2403 LACY LN, CARROLLTON, TX 75006-6514
(972) 869-3789
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
201997
CO
Other
Enumeration date
07/02/2018
Last updated
07/02/2018
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