Organization
WOODLAND PARK DENTAL PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW PEAK (CEO)
(719) 484-8490
Entity
Organization
Contact information
Practice address
150 MORNING SUN DR, SUITE 200W, WOODLAND PARK, CO 80863-9160
(719) 484-8490
(888) 790-7062
Mailing address
150 MORNING SUN DR, SUITE 200W, WOODLAND PARK, CO 80863-9160
(719) 484-8490
(888) 790-7062
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
08/08/2013
Last updated
08/08/2013
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