Organization
PEDODENT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN NELSON (OWNER)
(303) 422-6752
Entity
Organization
Contact information
Practice address
2700 E BRIDGE ST, BRIGHTON, CO 80601-2591
(303) 659-7700
Mailing address
8723 WADSWORTH BLVD STE B, ARVADA, CO 80003-0921
(303) 422-6752
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225013451
PEDIATRIC DENTISTRY
CO
Enumeration date
07/06/2021
Last updated
07/19/2021
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