Organization
RASOULI DENTAL CARE LLC
Active
Other names
Family Dental Clinic LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JINA RASOULI (DENTIST)
(720) 232-3095
Entity
Organization
Contact information
Practice address
1200 S WADSWORTH BLVD STE 200, LAKEWOOD, CO 80232-5434
(303) 733-7533
(303) 733-9826
Mailing address
1200 S WADSWORTH BLVD STE 200, LAKEWOOD, CO 80232-5434
(303) 733-7533
(303) 733-9826
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992997209
—
CO
Enumeration date
05/17/2019
Last updated
03/09/2020
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