Organization
PERFECT TEETH - EAST 104TH AVENUE P.C.
Active
Other names
Perfect Teeth - East 104th Avenue P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE SUMMERS (CREDENTIALING)
(303) 285-6098
Entity
Organization
Contact information
Practice address
2200 E 104TH AVE, #112, THORNTON, CO 80233-4404
(303) 452-4142
(303) 254-8360
Mailing address
2200 E 104TH AVE, #112, THORNTON, CO 80233-4404
(303) 452-4142
(303) 254-8360
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6097
CO
Other
Enumeration date
04/02/2007
Last updated
08/22/2020
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