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Organization

SOUTH BOULDER PEDIATRIC DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMANTHA GRAFFEO GARDNER DDS (OWNER/PEDIATRIC DENTIST)
(720) 441-2974
Entity
Organization

Contact information

Practice address
805 S BROADWAY ST STE 103, BOULDER, CO 80305-5972
(720) 441-2974
Mailing address
2945 MOORHEAD AVE, BOULDER, CO 80305-3342
(720) 441-2974

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
06/14/2023
Last updated
06/14/2023
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