Organization
BROOMFIELD PLAZA FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NINA R BOWLING DMD (DENTIST)
(303) 466-2935
Entity
Organization
Contact information
Practice address
5015 W 120TH AVE, BROOMFIELD, CO 80020-5606
(303) 466-2935
Mailing address
5015 W 120TH AVE, BROOMFIELD, CO 80020-5606
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
104995
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04013264
—
CO
Enumeration date
05/14/2008
Last updated
05/14/2008
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