Organization
MY LOCAL COLORADO DENTAL PRACTICE, LLC
Active
Parent organization
MY LOCAL COLORADO DENTAL PRACTICE, LLC
Other names
Cody Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
MY LOCAL COLORADO DENTAL PRACTICE, LLC
Authorized official
GREGORY KOSTELAC (RCM ANALYST)
(719) 372-5605
Entity
Organization
Contact information
Practice address
4301 E AMHERST AVE, DENVER, CO 80222-6790
(303) 758-5858
(719) 213-2311
Mailing address
6110 BARNES RD, COLORADO SPRINGS, CO 80922-2600
(719) 266-2717
(719) 213-2311
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/02/2022
Last updated
02/02/2022
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