Summit Smiles PLLC
Dentist, General Practice in Centennial, CO. Organization (NPI-2).
NPI number1013662774
StatusActive
Last updated in NPPESSep 7, 2022
Details
- NPI
- 1013662774
- Entity type
- Organization (NPI-2)
- Legal business name
- Summit Smiles PLLC
- Organization subpart
- Yes
- Enumeration date
- Feb 21, 2022
- Certification date
- Sep 7, 2022
- Last updated
- Sep 7, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
7300 E Arapahoe Rd Ste 500Centennial, CO 80112-6147
Phone 720-638-6361 · Fax 720-583-1354
Mailing address
7300 E Arapahoe Rd Ste 500Centennial, CO 80112-6147
Phone 720-638-6361 · Fax 720-583-1354
Authorized official
John Lydiatt
Owner
7206386361
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