Boulder Orthodontics
Dentist, Orthodontics and Dentofacial Orthopedics in Boulder, CO. Organization (NPI-2).
NPI number1154713402
StatusActive
Last updated in NPPESMar 3, 2021
Details
- NPI
- 1154713402
- Entity type
- Organization (NPI-2)
- Legal business name
- Boulder Orthodontics
- Organization subpart
- No
- Enumeration date
- Feb 24, 2015
- Certification date
- Mar 3, 2021
- Last updated
- Mar 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | 6921 | CO | Yes |
Practice location
2710 Pearl StBoulder, CO 80302-3814
Phone 303-449-3250 · Fax 303-449-1693
Mailing address
2710 Pearl StBoulder, CO 80302-3814
Phone 303-449-3250 · Fax 303-449-3219
Authorized official
Jamon Jensen
Owner
3034493250
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All 16 Orthodontics and Dentofacial Orthopedics Dentistry providers in Boulder · All 7,147 providers in Boulder
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