Organization
PEDIATRIC DENTAL ASSOCIATES OF COLORADO
Active
Other names
Children's Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA CARLSON-MARKS DDS (OWNER)
(303) 594-2214
Entity
Organization
Contact information
Practice address
3795 S COLORADO BLVD, ENGLEWOOD, CO 80113-4202
(303) 522-4703
Mailing address
730 POTOMAC ST, #306, AURORA, CO 80011-6703
(303) 537-0234
(720) 858-8248
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
7396
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04474562
—
CO
05
—
55931375
—
CO
05
—
56982771
—
CO
05
—
71905774
—
CO
Enumeration date
05/27/2008
Last updated
05/27/2008
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