Organization
STONEGATE DENTAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
R. KELLY PETERSEN D.D.S. (PRESIDENT)
(720) 851-7069
Entity
Organization
Contact information
Practice address
17021 LINCOLN AVE UNIT B, PARKER, CO 80134-3146
(720) 851-7069
Mailing address
17021 LINCOLN AVE UNIT B, PARKER, CO 80134-3146
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7978
CO
Other
Enumeration date
03/19/2007
Last updated
08/22/2020
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