Organization
CHILDREN'S DENTISTRY, BOULDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN WHALEN DDS (OWNER/PEDIATRIC DENTIST)
(720) 226-6061
Entity
Organization
Contact information
Practice address
3400 PENROSE PL STE 107, BOULDER, CO 80301-1809
(303) 443-8250
Mailing address
3400 PENROSE PL STE 107, BOULDER, CO 80301-1809
(303) 443-8250
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8954
—
CO
Enumeration date
09/07/2022
Last updated
09/07/2022
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