Individual
COLLIS JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
13065 E 17TH AVE, AURORA, CO 80045-2532
(303) 724-7073
Mailing address
1756 VINE STREET, DENVER, CO 80206
(303) 322-1177
(303) 322-1199
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
CO01476
CO
1223G0001X
General Practice Dentistry
Primary
04176
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02014769
—
CO
Enumeration date
09/01/2006
Last updated
09/01/2021
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