Organization
MY DENTIST INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY KRAINIK DDS (OWNER)
(303) 255-4855
Entity
Organization
Contact information
Practice address
3955 E 120TH AVE STE B, THORNTON, CO 80233-2075
(303) 255-4855
(303) 339-7912
Mailing address
3955 E 120TH AVE STE B, THORNTON, CO 80233-2075
(303) 255-4855
(303) 339-7912
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10-4900
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4947T
STATE LICSENCE
NV
Enumeration date
03/19/2008
Last updated
03/19/2008
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