Organization
PERFECT TEETH-SPECIALTY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGEL K MARTIN (CREDENTIALING SPECIALIST)
(254) 216-0661
Entity
Organization
Contact information
Practice address
1699 S COLORADO BLVD, BUILDING A, SUITE J, DENVER, CO 80222-4036
(303) 639-6000
Mailing address
7160 DALLAS PKWY STE 400, PLANO, TX 75024-7111
(254) 216-0661
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
10196
CO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10278
CO
Other
Enumeration date
09/16/2010
Last updated
04/19/2021
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