Organization
COLLIS JOHNSON JR DDS PC
Active
Other names
Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLLIS JOHNSON DDS (DENTIST OWNER PC)
(303) 322-1177
Entity
Organization
Contact information
Practice address
1756 VINE ST, DENVER, CO 80206
(303) 322-1177
(303) 322-1199
Mailing address
1756 VINE ST, DENVER, CO 80206
(303) 322-1177
(303) 322-1199
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
104176
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02014769
—
CO
01
—
1831291855
NATIONAL PROVIDER TYPEI
CO
Enumeration date
05/09/2007
Last updated
09/02/2008
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