Organization
COLORADO DENTAL PROFESSIONALS, LLC
Active
Parent organization
COLORADO DENTAL PROFESSIONALS, LLC
Other names
Columbine Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLORADO DENTAL PROFESSIONALS, LLC
Authorized official
CASSANDRA PETERSEN (CREDENTIALING TEAM LEAD)
(217) 540-8972
Entity
Organization
Contact information
Practice address
6691 W KEN CARYL AVE, LITTLETON, CO 80128-5755
(303) 979-4994
Mailing address
6691 W KEN CARYL AVE, LITTLETON, CO 80128-5755
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/14/2018
Last updated
03/14/2018
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