Healthcare Provider Details

I. General information

NPI: 1447248059
Provider Name (Legal Business Name): METROPOLITAN DENTAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 GLENARM PL #200
DENVER CO
80202-5034
US

IV. Provider business mailing address

1400 GLENARM PL #200
DENVER CO
80202-5034
US

V. Phone/Fax

Practice location:
  • Phone: 303-534-2626
  • Fax: 303-892-7953
Mailing address:
  • Phone: 303-534-2626
  • Fax: 303-892-7953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5451
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7334
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8953
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number106277
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5438
License Number StateCO

VIII. Authorized Official

Name: DR. DAWN M WHITE
Title or Position: OWNER
Credential: D.D.S.
Phone: 303-534-2626