| NPI | 1679127203 |
|---|---|
| Doing Business As | COLORADO ORTHODONTIC GROUP |
| Doing Business As | COLORADO DENTAL SPECIALISTS |
| Doing Business As | COLORADO ENDODONTIC GROUP |
| Entity Type | Organization |
| Authorized Contact | MICHELLE JOHNSON Credentialing Specialist 509-315-8338 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| 1223E0200X Dentist, Endodontics | |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2019-07-31 |