Organization
COLORADO DENTAL SPECIALIST PRACTICE, LLC
Active
Parent organization
COLORADO DENTAL SPECIALIST PRACTICE, LLC
Other names
Colorado Endodontic Group, Colorado Dental Specialists, All Smiles Orthodontics
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLORADO DENTAL SPECIALIST PRACTICE, LLC
Authorized official
MICHELLE JOHNSON (CREDENTIALING SPECIALIST)
(509) 315-8338
Entity
Organization
Contact information
Practice address
7685 MCLAUGHLIN RD STE 100, FALCON, CO 80831-4751
(719) 694-1929
Mailing address
7685 MCLAUGHLIN RD STE 100, FALCON, CO 80831-4751
(719) 694-1929
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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