4th Avenue Family Dentistry, LLC
Dentist, General Practice in Denver, CO. Organization (NPI-2).
NPI number1013100387
StatusActive
Last updated in NPPESAug 21, 2007
Details
- NPI
- 1013100387
- Entity type
- Organization (NPI-2)
- Legal business name
- 4th Avenue Family Dentistry, LLC
- Organization subpart
- No
- Enumeration date
- Aug 21, 2007
- Last updated
- Aug 21, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
390 University BlvdDenver, CO 80206-4125
Phone 303-333-0771 · Fax 303-333-0779
Mailing address
390 University BlvdDenver, CO 80206-4125
Phone 303-333-0771 · Fax 303-333-0779
Authorized official
Thomas Swain
Dentist
3033330771
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