Organization
NICKEL STREET DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TACI COOPER (OFFICE MANAGER)
(719) 241-3140
Entity
Organization
Contact information
Practice address
300 NICKEL ST, STE 10,11, BROOMFIELD, CO 80020-2013
(719) 241-3140
Mailing address
300 NICKEL ST, STE 10,11, BROOMFIELD, CO 80020-2013
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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