Organization
THORNTON VALLEY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN TYLER CETTIE (OWNER)
(832) 470-6344
Entity
Organization
Contact information
Practice address
16683 WASHINGTON ST BLDG 5, THORNTON, CO 80023-8970
(303) 450-3165
Mailing address
16683 WASHINGTON ST BLDG 5, THORNTON, CO 80023-8970
(303) 450-3165
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
00202110
CO
Other
Enumeration date
06/19/2017
Last updated
07/21/2022
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