Organization
FAMILY DENTISTRY
Active
Other names
Collis Johnson Jr DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLLIS JOHNSON JR. DDS (DENTIST/OWNER)
(303) 322-1177
Entity
Organization
Contact information
Practice address
1756 VINE STREET, DENVER, CO 80206
(303) 322-1177
(303) 322-1199
Mailing address
1756 VINE STREET, DENVER, CO 80206
(303) 322-1177
(303) 322-1199
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
104176
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02014769
—
CO
Enumeration date
12/27/2012
Last updated
12/27/2012
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