Organization
EDWARD J. BERTAGNOLLI, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN O. BERTAGNOLLI DDS. (DENTIST)
(303) 429-6222
Entity
Organization
Contact information
Practice address
7280 BRADBURN BLVD., WESTMINSTER, CO 80030
(303) 429-6222
(303) 429-7247
Mailing address
7280 BRADBURN BLVD., WESTMINSTER, CO 80030
(303) 429-6222
(303) 429-7247
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
HDL00161
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51424215
—
CO
Enumeration date
11/20/2014
Last updated
11/20/2014
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