38th Modern Dental Practice, LLC
Dentist, General Practice in Denver, CO. Organization (NPI-2).
NPI number1609390632
StatusActive
Last updated in NPPESAug 1, 2017
Details
- NPI
- 1609390632
- Entity type
- Organization (NPI-2)
- Legal business name
- 38th Modern Dental Practice, LLC
- Organization subpart
- No
- Enumeration date
- Aug 1, 2017
- Last updated
- Aug 1, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 122300000X | Dentist | – | – | |
| 1223P0300X | Dentist, Periodontics | – | – | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | – | – |
Other names
- 38th Modern Dental (Doing Business As)
Practice location
3550 W 38th Ave.#5
Denver, CO 80211
Phone 303-515-7008 · Fax 888-790-7062
Mailing address
6020 N Carefree CirColorado Springs, CO 80922-2402
Phone 719-266-2717 · Fax 888-790-7062
Authorized official
Scott Frederick
Owner
3035157008
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