Organization
COLORADO DENTAL TEAM PROFESSIONAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KETAN SUKKAWALA DDS (OWNER)
(979) 450-1116
Entity
Organization
Contact information
Practice address
10170 CHURCH RANCH WAY UNIT 110, WESTMINSTER, CO 80021-6059
(720) 330-5571
Mailing address
182 INDUSTRIAL RD, GLEN ROCK, PA 17327-8626
(717) 759-4375
(717) 759-4336
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
09/03/2021
Last updated
03/21/2023
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