Organization
MOUNTAIN DENTAL PC
Active
Parent organization
MOUNTAIN DENTAL INC
Other names
Mountain Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOUNTAIN DENTAL INC
Authorized official
LORI PELKE (PROFESSIONAL SERVICES)
(715) 926-5050
Entity
Organization
Contact information
Practice address
300 NICKEL ST STE 11, BROOMFIELD, CO 80020-2097
(303) 635-1816
Mailing address
300 NICKEL ST STE 11, BROOMFIELD, CO 80020-2097
(303) 635-1816
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/18/2008
Last updated
12/18/2008
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