Organization
CCDI PARKER PDC PLLC
Active
Other names
Cherry Creek Dental Implant
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB WARNER (CREDENTIALING MANAGER)
(801) 691-1701
Entity
Organization
Contact information
Practice address
10841 CROSSROADS DR STE 9, PARKER, CO 80134-9090
(303) 333-1844
Mailing address
PO BOX 970057, OREM, UT 84097-0309
(801) 305-3460
(801) 335-6551
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
05/30/2019
Last updated
05/30/2019
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