Organization
COLORADO DENTAL PROFESSIONALS, LLC
Active
Parent organization
COLORADO DENTAL PROFESSIONALS, LLC
Other names
Boulder County Smiles
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLORADO DENTAL PROFESSIONALS, LLC
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization
Contact information
Practice address
1140 W SOUTH BOULDER RD STE 201, LAFAYETTE, CO 80026-8910
(720) 623-1140
Mailing address
1140 W SOUTH BOULDER RD STE 201, LAFAYETTE, CO 80026-8910
(720) 623-1140
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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