Organization
ROCKY MOUNTAIN DENTAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ONTIVEROS D.D.S (DENTIST)
(303) 233-1335
Entity
Organization
Contact information
Practice address
2475 WADSWORTH BLVD, LAKEWOOD, CO 80214-5713
(303) 233-1335
(303) 233-8361
Mailing address
2475 WADSWORTH BLVD, LAKEWOOD, CO 80214-5713
(303) 233-1335
(303) 233-8361
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6875
CO
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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