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Organization

COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC

Active
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Organization

COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC

Active
Parent organization
COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC
Other names
KIP Orthodontics
Organization subpart
Yes

Provider details

NPI number
Legal business name
COLORADO DENTAL ORTHODONTIST PRACTICE, PLLC
Authorized official
MICHELLE JOHNSON (CREDENTIALING SPECIALIST)
(509) 315-8338
Entity
Organization

Contact information

Practice address
5021 S JELLISON WAY UNIT C, LITTLETON, CO 80123-7377
(720) 608-5557
Mailing address
5021 S JELLISON WAY UNIT C, LITTLETON, CO 80123-7377

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Enumeration date
05/05/2021
Last updated
05/05/2021
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