Organization
CO SPECIALTY DENTAL SERVICES, PLLC
Active
Parent organization
CO SPECIALTY DENTAL SERVICES, PLLC
Other names
Foothills Pediatric Dentistry (Lafayette)
Organization subpart
Yes
Provider details
NPI number
Legal business name
CO SPECIALTY DENTAL SERVICES, PLLC
Authorized official
CHARLOTTE DASCH (DIRECTOR OF CREDENTIALING AND PR)
(504) 638-0303
Entity
Organization
Contact information
Practice address
1140 W SOUTH BOULDER RD STE 102, LAFAYETTE, CO 80026-8910
(303) 604-9500
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
07/08/2024
Last updated
03/11/2025
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